Z68.38 ICD-10-CM Code: Body mass index [BMI] 38.0-38.9, adult
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Body mass index [BMI] (Z68)
Z68.38
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBody mass index [BMI] 38.0-38.9, adult
A measurement of body weight relative to height (BMI) between 38.0 and 38.9 in adults, indicating obesity.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Z68.38 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z68.38 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z68.38 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z68.38 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z68.38 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z68.38 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z68.38 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is Z68.38 an HCC code?
No. Z68.38 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z68.38 is the ICD-10-CM diagnosis code for body mass index [bmi] 38.0-38.9, adult. A measurement of body weight relative to height (BMI) between 38.0 and 38.9 in adults, indicating obesity. Z68.38 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering body mass index [bmi] (z68).
Z68.38 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
BMI codes are status codes used for documentation purposes and should be reported alongside the diagnosis of obesity (E66.x) when applicable.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z68.38 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •BMI codes are status codes used for documentation purposes and should be reported alongside the diagnosis of obesity (E66.x) when applicable
- •Ensure the BMI calculation is documented in the medical record; these codes require actual BMI values, not estimates