2027 ICD-10-CM Diagnosis Code Z73.812Behavioral insomnia of childhood, combined type

ICD-10-CM Codes›Z00–Z99›Z69-Z76›Z73

ICD-10-CM Z73.812
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z73.812 is a billable ICD-10-CM diagnosis code for behavioral insomnia of childhood, combined type. 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 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
Z73.812
Billable Status
Yes — Valid for Submission
Code Describes
Behavioral insomnia of childhood, combined type
Short Description
Behavioral insomnia of childhood, combined 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 CodeZ73.812Behavioral insomnia of childhood, combined type

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z73.812.

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

Z73.812 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services in other circumstances (Z69-Z76).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Behavioral insomnia of childhood
  • Behavioral insomnia of childhood, combined type

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z73.812: its own notes plus those printed at Z73 and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Z73 Problems related to life management difficulty applies to 14 codes
  • problems related to socioeconomic and psychosocial circumstances (Z55-Z65)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • 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 Z73.812, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming Z73.812: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z72 Problems related to lifestyle
    problems related to life-management difficulty (Z73.-) names Z73.-, 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.

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 Z73.812 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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z73.812Overview

What is the ICD-10 code for behavioral insomnia of childhood, combined type?

The ICD-10-CM code for behavioral insomnia of childhood, combined type is Z73.812 (sometimes written as Z73812). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z73.812 (Behavioral insomnia of childhood) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report behavioral insomnia of childhood, combined type on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z73.812 group to?

On inpatient claims, behavioral insomnia of childhood, combined type 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 Z73.812 be a principal diagnosis?

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

Who can Z73.812 be reported for?

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