Z68.44 ICD-10-CM Code: Body mass index [BMI] 60.0-69.9, adult
Z68.44 maps to CMS-HCC V28 48. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Body mass index [BMI] (Z68)
Z68.44
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBody mass index [BMI] 60.0-69.9, adult
A measurement of body weight relative to height (BMI) between 60.0 and 69.9 in adults, indicating severe obesity.
Buddy Insight
This code indicates severe obesity with BMI 60.
CMS-HCC V28
MappedHCC 48
Coefficient HCC 48: 0.186 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
Context neededHCC 22
Coefficient needs member context
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Kilograms per meters squaredInherited from Z68
Excludes 2
OfficialNo Excludes 2 notes are included in this display for Z68.44. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for Z68.44. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for Z68.44. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for Z68.44. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Z68.44. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for Z68.44. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 Z68.44 an HCC code?
Yes. Z68.44 (Body mass index [BMI] 60.0-69.9, adult) maps to HCC 48, Morbid Obesity under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.186. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: Z68.44 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
- Z68.44
- Description
- Body mass index [BMI] 60.0-69.9, adult
- HCC (V28)
- HCC 48 — Morbid Obesity
- RAF reference coefficient
- 0.186
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work Z68.44 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for Z68.44
For Z68.44, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
Z68.44 is the ICD-10-CM diagnosis code for body mass index [bmi] 60.0-69.9, adult. A measurement of body weight relative to height (BMI) between 60.0 and 69.9 in adults, indicating severe obesity. Z68.44 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, Z68.44 maps to Morbid Obesity (HCC 48) with a source-labeled community, non-dual, aged reference coefficient of 0.186. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
BMI 60.0-69.9, adult, documented super-morbid obesity. Extremely high-BMI patients are frequently under-coded because some EMR workflows don't auto-populate the matching Z68 code. For Z68.44, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for Z68.44 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •BMI 60.0-69.9, adult, documented super-morbid obesity. Extremely high-BMI patients are frequently under-coded because some EMR workflows don't auto-populate the matching Z68 code.
- •Check that E66.01 or E66.2 is on the claim whenever Z68.44 appears, the standalone Z68 without the E66 does not satisfy HCC 48 coding rules.
Clinical Significance
This code indicates severe obesity with BMI 60.0-69.9, representing extremely high health risk requiring intensive medical management and likely urgent surgical intervention consideration. Morbid obesity at this level is associated with significantly increased mortality and complications requiring specialized comprehensive care.
Documentation Requirements
- ✓Documented BMI calculation between 60.0-69.9
- ✓Patient age confirmed as adult (18+ years)
- ✓Height and weight measurements supporting BMI calculation
- ✓Clinical assessment of obesity-related health impacts
- ✓Provider documentation of obesity as medical condition
- ✓Multiple associated comorbidities typically documented
- ✓Multidisciplinary treatment plan including surgical evaluation
- ✓Specialist referrals for comprehensive obesity management