ICD-10 Z68.1
Billable / Specific CCBody mass index [BMI] 19.9 or less, adult
About ICD-10-CM Z68.1
ICD-10-CM code Z68.1 represents Body mass index [BMI] 19.9 or less, adult. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z68). The 2026 edition of ICD-10-CM Z68.1 became effective on October 1, 2025.
Coding Tips for Z68.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Z68.1 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, CC
codes Body mass index [BMI] 19.9 or less, adult. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for Z68.1
Local Coverage Determinations (LCDs) from CMS MACs that list Z68.1 as a covered diagnosis.
Showing top 10 of 24 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z68.1.
5 Medicare
2 Aetna
CPT Codes Commonly Billed with Z68.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 64584 CMS LCD: Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea CMS LCD
- 64582 CMS LCD: Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea CMS LCD
- 64583 CMS LCD: Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea CMS LCD
- C8009 CMS LCD: Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea CMS LCD
- C8007 CMS LCD: Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea CMS LCD
- C8008 CMS LCD: Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea CMS LCD
Convert Z68.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Z68.1 | V850 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z68.1
Other codes in section Z68 (Body mass index (BMI)).
ICD-10 Z68.1, Billing FAQ
Is ICD-10 code Z68.1 billable? +
Yes, Z68.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is Z68.1 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with Z68.1? +
Procedures frequently paired with Z68.1 include: 64584, 64582, 64583, C8009, C8007.
What ICD-9 codes does Z68.1 map to? +
Per CMS GEMs, Z68.1 maps to ICD-9 codes: V850. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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