For Healthcare Providers

A resource you can confidently recommend to your patients.

Built by a clinician who got tired of answering the same prior auth questions twice a day. Everything here is designed to save you time, support your documentation, and give your patients a trusted place to go between appointments.

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Professional Education Disclaimer: Resources on this page are shared for general educational and informational purposes among healthcare professionals. They do not constitute clinical protocols, treatment guidelines, or legal advice. Prior authorization requirements and payer policies vary by plan and change frequently — always verify directly with the relevant payer. Content reflects the author's professional experience and is not intended to replace individual clinical judgment.

Jump to: Prior Authorization Documentation Guidance ICD-10 Reference Patient Handouts Compounding Guide Contact & Collaborate

Section 1

Prior Authorization Resources

The most common reason GLP-1s don't get covered isn't clinical — it's documentation. These resources are designed to close that gap and help your patients get the medication their clinical picture supports.

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Most Downloaded
GLP-1 Prior Authorization Checklist
Before you submit, confirm you have every element documented. Built from the most common denial reasons across major commercial payers. One page. Print it. Post it.
Download PDF
  • Primary obesity ICD-10 code documented (E66.01 or E66.09)
  • BMI documented with Z68 code at current visit
  • At least one obesity-related comorbidity coded
  • Lifestyle intervention attempts documented with dates
  • Step therapy requirements addressed (if applicable)
  • Shared decision-making language included in note
  • Letter of medical necessity attached (if required by payer)
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Documentation Language
Medical Necessity Language Library
Example phrases for documenting BMI, comorbidities, prior treatment attempts, and functional impairment in language payers respond to. Adapt to your patient — don't copy verbatim.
Download Guide
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Appeals Support
Common Denial Reasons & Appeal Language
The most frequent GLP-1 denial reasons — wrong ICD-10, missing comorbidity, step therapy not documented — and example language for addressing each in an appeal letter.
Download Guide
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Step Therapy
Documenting Prior Lifestyle Intervention
Most payers require documentation that a patient attempted lifestyle interventions before approving a GLP-1. Here is how to document that history clearly and compliantly.
Download Guide
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Payer Landscape
Commercial vs. Medicare vs. Medicaid Coverage Overview
General guidance on how GLP-1 coverage differs across payer types. Note: policies change frequently — always verify current criteria directly with the relevant payer before submitting.
Read Overview

Section 2

Documentation Guidance

A simple framework for documenting obesity visits in a way that supports coverage — without overhauling your workflow. Not a clinical protocol. Just practical structure from someone who has been in clinic.

Framework 01
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Visit Documentation
Five Things to Document at Every Obesity Visit
Current BMI, active comorbidities, prior treatment history, patient-stated goals, and response to current treatment. Hit these five and your note supports coverage.
Download One-Pager
Framework 02
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GLP-1 Initiation
GLP-1 Initiation Visit Documentation Elements
The components that strengthen a GLP-1 initiation note: shared decision-making language, risk/benefit discussion, patient education provided, and follow-up plan. Examples, not a protocol.
Download Guide
Framework 03
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Ongoing Visits
Documenting GLP-1 Follow-Up and Dose Titration
What to capture at follow-up visits: weight trajectory, side effect discussion, titration rationale, and adherence — the elements that support continued coverage and refill approvals.
Download Guide

Section 3

ICD-10 Quick Reference

The codes that matter for obesity medicine — including the comorbidity codes that strengthen medical necessity for GLP-1 prior authorizations. Publicly available reference information.

Code Description PA Relevance
E66.01
Morbid (severe) obesity due to excess calories Primary
BMI ≥ 40, or BMI ≥ 35 with comorbidities. Most payers require this or E66.09 as primary dx.
 Required for most GLP-1 PAs
E66.09
Other obesity due to excess calories Primary
BMI 30–39.9. Some payers require comorbidities alongside this code.
 Required for most GLP-1 PAs
Z68.3x–Z68.4x
BMI range codes BMI
E.g., Z68.35 = BMI 35.0–35.9. Document at every visit — supports continuity of medical necessity.
 Strongly recommended every visit
E11.xx
Type 2 diabetes mellitus Comorbidity
Strongest comorbidity for GLP-1 coverage. Many payers approve without obesity codes when T2D is primary dx (for Ozempic/Victoza).
 High impact — include when present
I10
Essential hypertension Comorbidity
Common comorbidity that strengthens medical necessity when combined with obesity code.
 Include when present
G47.33
Obstructive sleep apnea Comorbidity
Recognized obesity comorbidity. Strengthens medical necessity. Include when diagnosed.
 Include when present
K76.0
Fatty (change of) liver, NAFLD/MASLD Comorbidity
Increasingly recognized in GLP-1 coverage decisions. Tirzepatide specifically being studied for NASH.
 Include when present
E28.2
Polycystic ovarian syndrome (PCOS) Comorbidity
Relevant for female patients. Strengthens PA for GLP-1 with insulin resistance component.
 Include when present

Section 4

Patient Education Handouts

Printable, clinician-created handouts designed to supplement what you tell patients in the exam room. All content is from InformedPlate.com — free to share.

Download all handouts
GLP-1 medication guidance
GLP-1 Medications
What to Expect in Your First Month on a GLP-1
PDF · 1 page · Print-ready
Nutrition guidance for GLP-1 patients
Nutrition
Protein Goals on a GLP-1: A Patient Guide
PDF · 1 page · Print-ready
Menopause and weight management
Menopause & Hormones
Menopause Symptom Checklist — For Your Next Visit
PDF · 1 page · Print-ready
Nausea management for GLP-1 patients
Side Effects
Managing Nausea on a GLP-1: Evidence-Based Tips
PDF · 1 page · Print-ready
Weight management nutrition
Weight Management
10 Things to Know About Sustainable Weight Loss
PDF · 2 pages · Print-ready
Informed Plate website overview for patients
About This Site
Informed Plate — What to Tell Your Patients
PDF · 1 page · Waiting room ready

Section 5

The Compounding Question

Your patients are seeing compounded GLP-1 ads online. Here is a clear, clinically accurate summary to help you have that conversation — and a patient-facing handout to leave in their hands.

Patient Handout: The Compounding Question
What your patients need to understand before deciding
  • Compounded GLP-1s are not the same as brand-name medications
  • They are not FDA-approved for safety, purity, or potency
  • Real safety reports exist — this is not theoretical
  • The shortage exemption that allowed compounding is ending
  • If cost is the driver, there may be better options worth exploring
Download Patient Handout (PDF)
Free to print and share with patients

Get in Touch

Contact & Collaborate

Have a content question, want to be listed as a recommending practice, or need a custom patient handout for your population? Reach out.

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Practices that recommend Informed Plate to patients can be listed on the site. A small signal of trust that means a lot to patients looking for guidance.
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Provider Resource Newsletter
Get notified when new prior auth guides, documentation resources, or patient handouts are added. No spam — just new tools when they're ready.
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Request a Custom Handout
Need a patient-facing resource tailored to your practice's specific population or most common questions? Reach out and let's discuss.
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Content or Resource Questions
Something on the site that needs clarification, updating, or expanding? All feedback from providers is taken seriously and often shapes new content.
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