2027 ICD-10-CM Diagnosis Code Z68.53Body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age
Z68.53 is a billable ICD-10-CM diagnosis code for body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z68.53.
Present on Admission (POA)Billing
Z68.53 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Body mass index (BMI) (Z68).
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z68.53: its own notes plus those printed at Z68 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Notes
General instructions on how these codes are used.
- BMI adult codes are for use for persons 20 years of age or older
- BMI pediatric codes are for use for persons 2-19 years of age.
- These percentiles are based on the growth charts published by the Centers for Disease Control and Prevention (CDC)
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z68.53, its category, or a range that includes it.
Use Additional Code 5
These codes say to use an additional code from the note, and Z68.53 is one of the codes named.
- E66 Overweight and obesitycode to identify body mass index (BMI), if known, for adults (Z68.1-Z68.45) or pediatrics (Z68.5-) names Z68.5-, which includes this code
- E88.82 Obesity due to disruption of MC4R pathwaycode to identify body mass index (BMI), if known (Z68.-) names Z68.-, which includes this code
- R63.6 Underweightcode to identify body mass index (BMI), if known (Z68.-) names Z68.-, which includes this code
- Z15.2 Genetic susceptibility to obesitycode to identify body mass index (BMI), if known (Z68.-) names Z68.-, which includes this code
- Z71.3 Dietary counseling and surveillancecode to identify body mass index (BMI), if known (Z68.-) names Z68.-, which includes this code
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Body Weight
Body weight is the total mass of your body. Keeping track of your weight is one way to check for changes in your health, but it can't tell you the whole story. That's because your weight includes muscle, bone, fat, and water. Also, everyday factors can play a role in your weight, such as your:
The full article covers:
- What is body weight?
- What factors help determine a healthy body weight?
- What are body weight ranges?
- What if I have a sudden gain or loss of weight?
- How can I maintain a healthy body weight?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z68.53 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z68.53Overview
Is Z68.53 (Body mass index [BMI] pediatric) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z68.53 group to?
On inpatient claims, body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z68.53 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z68.53 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age on inpatient claims. The code appears in the Body mass index (BMI) (Z68) range of the CMS exempt list.
What is the ICD-9 equivalent of Z68.53?
Under the General Equivalence Mappings, body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age converts to ICD-9-CM V85.53 (BMI,pediatric 85% - <95%). The mapping is a direct match.
