Z68.56 Body mass index [BMI] pediatric, greater than or equal to 140% of the 95th percentile for age

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis. Exempt from present-on-admission (POA) reporting.

Applies from Z68 Body mass index [BMI]

Applicable to

• Kilograms per meters squared

Notes

• 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)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 48 — Morbid Obesity
• CMS-HCC V22: HCC 22 — Morbid Obesity
• ESRD V24: HCC 22

MS-DRG index

Defines the logic of DRG(s) 640-641 in MDC 10.

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to Z68.56

Back-references to Z68.5

• Use Additional: E66 Overweight and obesity ("code to identify body mass index (BMI), if known, for adults (Z68.1-Z68.45) or pediatrics (Z68.5-)")

Back-references to Z68

• Use Additional: E88.82 Obesity due to disruption of MC4R pathway ("code to identify body mass index (BMI), if known (Z68.-)")
• Use Additional: R63.6 Underweight ("code to identify body mass index (BMI), if known (Z68.-)")
• Use Additional: Z15.2 Genetic susceptibility to obesity ("code to identify body mass index (BMI), if known (Z68.-)")
• Use Additional: Z71.3 Dietary counseling and surveillance ("code to identify body mass index (BMI), if known (Z68.-)")

Diagnosis Index entries for Z68.56

• Body, bodies › mass index (BMI) › pediatric › greater than or equal to 140% of the 95th percentile for age

Nearby codes

• Z68.51 Body mass index [BMI] pediatric, less than 5th percentile for age
• Z68.52 Body mass index [BMI] pediatric, 5th percentile to less than 85th percentile for age
• Z68.53 Body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age
• Z68.54 Body mass index [BMI] pediatric, 95th percentile for age to less than 120% of the 95th percentile for age
• Z68.55 Body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age
• Z68.56 Body mass index [BMI] pediatric, greater than or equal to 140% of the 95th percentile for age (this code)