ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z68.44

Billable / Specific HCC v28: 22 CC

Body mass index [BMI] 60.0-69.9, adult

Z68
Block
0
Synonyms
61
LCDs
13
Payer Policies
0
Linked CPTs

About ICD-10-CM Z68.44

ICD-10-CM code Z68.44 represents Body mass index [BMI] 60.0-69.9, adult. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z68). The 2026 edition of ICD-10-CM Z68.44 became effective on October 1, 2025.

Coding Tips for Z68.44

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

Z68.44 is a CMS-HCC v28 risk-adjustment code (category 22). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

Z68.44 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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 22
ESRD-HCC
Category 22
RxHCC (Part D)
Category 22

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Body mass index [BMI] 60.0-69.9, adult. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for Z68.44

Local Coverage Determinations (LCDs) from CMS MACs that list Z68.44 as a covered diagnosis.

61 LCDs

Showing top 10 of 61 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Vitamin D Assay Testing
Article ID: 57736, Effective: 2024-10-01 00:00:00, 553 covered, 0 non-covered
CPT 82652 →
CMS LCD: Billing and Coding: Vitamin D Assay Testing
Article ID: 57736, Effective: 2024-10-01 00:00:00, 553 covered, 0 non-covered
CPT 82306 →
CMS LCD: Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed
Article ID: 56841, Effective: 2023-10-01 00:00:00, 759 covered, 1 non-covered
CPT 82306 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43888 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43846 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43771 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43659 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43845 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43886 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43774 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z68.44.

13 policies

5 Medicare

Laparoscopic Sleeve Gastrectomy (LSG) � Medical Policy Article
Policy ID: ART-52447
Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
Policy ID: ART-54923
Billing and Coding: Assays for Vitamins and Metabolic Function
Policy ID: ART-56416
Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Policy ID: ART-56422

CPT Codes Commonly Billed with Z68.44

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for Z68.44

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert Z68.44 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Z68.44 V8544 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 Z68.44, Billing FAQ

Is ICD-10 code Z68.44 billable? +

Yes, Z68.44 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does Z68.44 affect Medicare Advantage HCC risk adjustment? +

Yes. Z68.44 maps to CMS-HCC v28 category 22. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is Z68.44 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 ICD-9 codes does Z68.44 map to? +

Per CMS GEMs, Z68.44 maps to ICD-9 codes: V8544. 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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