What is ICD-10 code Z68.41?

Z68.41 is the ICD-10-CM diagnosis code for Body mass index [BMI] 40.0-44.9, adult. A measurement of body weight relative to height (BMI) between 40.0 and 44.9 in adults, indicating severe obesity. Z68.41 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. Z68.41 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. Z68.41 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. Z68.41 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for Z68.41?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For Z68.41, V28 maps to Morbid Obesity at RAF 0.186 while V24 mapped to Morbid Obesity at RAF 0.250. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting Z68.41?

BMI 40.0-44.9, adult, a supporting code that identifies the BMI category. Per ICD-10-CM convention, Z68.* is reported with the associated E66.* code and documents the BMI measurement underlying the obesity code. Z68.* is reported for BMI values when the provider documents or acknowledges the BMI. Do not report the Z68 code alone without the underlying E66.* obesity code. Z68.41 (BMI 40.0-44.9) maps to V28 HCC 48 (Morbid Obesity) at RAF 0.186 in the model. But ICD-10-CM guidelines require BMI codes to be paired with a provider-documented obesity diagnosis, you cannot code BMI from a vital-sign entry alone, so report it with E66.01/E66.2/E66.813 rather than standalone. Because Z68.41 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM Z68.41: Body mass index [BMI]

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Code lookupZ68.41Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Body mass index [BMI] (Z68)

Z68.41

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Body mass index [BMI] 40.0-44.9, adult

A measurement of body weight relative to height (BMI) between 40.0 and 44.9 in adults, indicating severe obesity.

Buddy Insight

This code indicates severe obesity with BMI 40.

CMS-HCC V28

Mapped

HCC 48

Morbid Obesity

RAF 0.186

CMS-HCC V24

Mapped

HCC 22

Morbid Obesity

RAF 0.250

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 22

Morbid Obesity

RAF 0.081

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

Z68Body mass index [BMI]

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

Z68.41Body mass index [BMI] 40.0-44.9, adult

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Z68.41 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z68.41 in this effective period.

Related Child Codes

Official

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 Z68.41 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z68.41 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z68.41 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z68.41 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z68.41 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented BMI calculation between 40.0-44.9

Patient age confirmed as adult (18+ years)

Height and weight measurements supporting BMI calculation

Clinical assessment of obesity-related health impacts

MEAT Support

HCC Buddy guidance

Documented BMI calculation between 40.0-44.9

Patient age confirmed as adult (18+ years)

Height and weight measurements supporting BMI calculation

Clinical assessment of obesity-related health impacts

Audit Caution

HCC Buddy guidance

Using wrong BMI range when specific value is documented

Coding pediatric BMI codes for adult patients

Missing associated obesity diagnosis codes when clinically significant

Not verifying adult vs pediatric age cutoffs

Common Mistakes

HCC Buddy guidance

Z68.42 — Use when BMI is 45.0-49.9 instead of 40.0-44.9

Z68.39 — Use when BMI is 35.0-39.9 (obesity Class II)

E66.01 — Use for morbid obesity due to excess calories, not BMI code alone

Z68.54 — Use for pediatric BMI >95th percentile, not adult BMI

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is Z68.41 an HCC code?

Yes. Z68.41 (Body mass index [BMI] 40.0-44.9, adult) maps to Morbid Obesity under the CMS-HCC V28 risk adjustment model (and Morbid Obesity under V24), with a community non-dual aged RAF of 0.186. It is billable for payment year 2026.

Coder answer: Z68.41 is billable and maps to V28 HCC 48, Morbid Obesity. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: Z68.41
Description: Body mass index [BMI] 40.0-44.9, adult
HCC (V28): HCC 48 — Morbid Obesity
RAF: 0.186
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 48, Morbid Obesity

0.186

V24HCC 22, Morbid Obesity

0.250

ESRDHCC 22, Morbid Obesity

0.081

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work Z68.41 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for Z68.41

For Z68.41 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed Z68.41 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

Z68.41 is the ICD-10-CM diagnosis code for body mass index [bmi] 40.0-44.9, adult. A measurement of body weight relative to height (BMI) between 40.0 and 44.9 in adults, indicating severe obesity. Z68.41 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).

Under the CMS-HCC V28 risk adjustment model, Z68.41 maps to Morbid Obesity (HCC 48) with a community, non-dual, aged base RAF weight of 0.186. Under the older V24 model, Z68.41 mapped to the same category but with a base RAF weight of 0.250, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

BMI 40.0-44.9, adult, a supporting code that identifies the BMI category. Per ICD-10-CM convention, Z68.* is reported with the associated E66.* code and documents the BMI measurement underlying the obesity code. Because Z68.41 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z68.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•BMI 40.0-44.9, adult, a supporting code that identifies the BMI category. Per ICD-10-CM convention, Z68.* is reported with the associated E66.* code and documents the BMI measurement underlying the obesity code.
•Z68.* is reported for BMI values when the provider documents or acknowledges the BMI. Do not report the Z68 code alone without the underlying E66.* obesity code.
•Z68.41 (BMI 40.0-44.9) maps to V28 HCC 48 (Morbid Obesity) at RAF 0.186 in the model. But ICD-10-CM guidelines require BMI codes to be paired with a provider-documented obesity diagnosis, you cannot code BMI from a vital-sign entry alone, so report it with E66.01/E66.2/E66.813 rather than standalone.

Clinical Significance

This code indicates severe obesity with BMI 40.0-44.9, representing significant health risk requiring ongoing medical management and intervention. Morbid obesity at this level substantially increases risk for cardiovascular disease, diabetes, and other complications requiring intensive care coordination.