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Z68.4 ICD-10-CM Code: Body mass index [BMI] 40 or greater, 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)

Z68.4

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Body mass index [BMI] 40 or greater, adult

Body mass index [BMI] 40 or greater, adult

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Z68Body mass index [BMI]
Z68.4Body mass index [BMI] 40 or greater, adult

Inclusion Terms

Official
  • Kilograms per meters squared

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z68.4 in this effective period.

Related Child Codes

Official
Z68.41Body mass index [BMI] 40.0-44.9, adult
Z68.42Body mass index [BMI] 45.0-49.9, adult
Z68.43Body mass index [BMI] 50.0-59.9, adult
Z68.44Body mass index [BMI] 60.0-69.9, adult
Z68.45Body mass index [BMI] 70 or greater, adult

Includes

Official

ICD-10-CM does not list Includes notes for Z68.4 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z68.4 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z68.4 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z68.4 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z68.4 in this effective period.

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.

What This Code Means

Z68.4 is the ICD-10-CM diagnosis code for body mass index [bmi] 40 or greater, adult. Z68.4 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).

Header codes like Z68.4 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Z68.4's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z68.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

More on Z68.4

Related condition guides

Referenced in blog posts

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