Z73.812
BillableBehavioral insomnia of childhood, combined type
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z73.812 an HCC code?
No. Z73.812 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
Z73.812 is the ICD-10-CM diagnosis code for behavioral insomnia of childhood, combined type. A sleep disorder in children that combines both sleep-onset association problems and limit-setting difficulties, making it difficult for the child to fall asleep independently. Z73.812 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons encountering health services in other circumstances (z69-z76).
Z73.812 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.
Use this code when documentation clearly shows both sleep-onset associations AND inadequate limit-setting are contributing factors.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z73.812 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when documentation clearly shows both sleep-onset associations AND inadequate limit-setting are contributing factors
- •Requires comprehensive behavioral intervention addressing both components of the sleep problem