2026 ICD-10-CM Diagnosis Code Z68.55Body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age

ICD-10-CM Codes›Z00–Z99›BMI›Z68

ICD-10-CM Z68.55
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z68.55 is a billable ICD-10-CM diagnosis code for body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 640 through 641. 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 Obesity.

Code Identity

ICD-10-CM Code
Z68.55
Billable Status
Yes — Valid for Submission
Code Describes
Body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age
Short Description
Body mass index ped, 120% 95% for age to < 140% 95% for age
Parent Code
Z68.5
Body mass index [BMI] pediatric

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionBMIBody mass index (Z68)
CategoryZ68Body mass index [BMI]
This CodeZ68.55Body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z68.55.

Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Present on Admission (POA)Billing

Z68.55 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Body, bodies
      • mass index (BMI)
        • pediatric
          • 120% of the 95th percentile for age to less than 140% of the 95th percentile for age

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR END009
Obesity
Default principal diagnosis: inpatient No · outpatient No

Code History & ChangesHistory

Replacement Z68.55 replaces the following previously assigned code(s):

  • Z68.54 - BMI pediatric, greater than or equal to 95% for age
  • Z68.54 - Body mass index ped, 95% for age to < 120% of 95% for age
  • Z68.54 - Body mass index pediatric, > or equal to 95% for age
FY 2025AddedAdded to the ICD-10-CM code setEffective October 1, 2024.
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z68.55Overview

Is Z68.55 (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, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z68.55 group to?

On inpatient claims, body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age maps to MS-DRG 640, 641, with relative weights from 0.7782 to 1.3356 depending on complications. Higher weights mean higher Medicare reimbursement.

Can Z68.55 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z68.55 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, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age on inpatient claims.