2026 ICD-10-CM Diagnosis Code Z73.811Behavioral insomnia of childhood, limit setting type

ICD-10-CM Codes›Z00–Z99›Z69-Z76›Z73

ICD-10-CM Z73.811
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z73.811 is a billable ICD-10-CM diagnosis code for behavioral insomnia of childhood, limit setting type. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is restricted by the Medicare Code Editor to pediatric patients (age 0 through 17), not accepted as a principal diagnosis, and exempt from POA reporting. Coders also document this condition as behavioral insomnia of childhood. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Lifestyle/life management factors.

Code Identity

ICD-10-CM Code
Z73.811
Billable Status
Yes — Valid for Submission
Code Describes
Behavioral insomnia of childhood, limit setting type
Short Description
Behavioral insomnia of childhood, limit setting type
Same as the full description in the CMS dataset.
Parent Code
Z73.81
Behavioral insomnia of childhood

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ69-Z76Persons encountering health services in other circumstances
CategoryZ73Problems related to life management difficulty
This CodeZ73.811Behavioral insomnia of childhood, limit setting type

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z73.811.

Pediatric diagnoses
The Medicare Code Editor detects inconsistencies in pediatric cases by checking a patient's age and any diagnosis on the patient's record. The pediatric code edits apply to patients age range is 0–17 years inclusive (e.g., Reye's syndrome, routine child health exam).
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

Z73.811 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Behavioral insomnia of childhood
  • Behavioral insomnia of childhood, limit setting type
  • Limit-setting sleep disorder

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.

    • Insomnia(organic)
      • behavioral, of childhood
        • limit setting type

Clinical ClassificationClinical

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

CCSR FAC020
Lifestyle/life management factors
Default principal diagnosis: inpatient No · outpatient Yes

Clinical InformationClinical

  • Behavioral Insomnia of Childhood

    a childhood disorder characterized by difficulty initiating and maintaining sleep due to negative sleep associations, refusal to go to bed, and/or repeated attempts to delay bedtime.

Convert Z73.811 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V69.5 Behav insomnia-childhood
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z73.811Overview

Is Z73.811 (Behavioral insomnia of childhood) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report behavioral insomnia of childhood, limit setting type on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can Z73.811 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because behavioral insomnia of childhood, limit setting type describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Who can Z73.811 be reported for?

The Medicare Code Editor checks behavioral insomnia of childhood, limit setting type against patient demographics: this code is intended for pediatric patients (age 0 through 17). Claims outside these limits are flagged as inconsistent.

Is Z73.811 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 behavioral insomnia of childhood, limit setting type on inpatient claims.

What is the ICD-9 equivalent of Z73.811?

Under the General Equivalence Mappings, behavioral insomnia of childhood, limit setting type converts to ICD-9-CM V69.5 (behav insomnia-childhood). The mapping is approximate, so confirm the match fits the documentation.