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Z68.53 ICD-10-CM Code: Body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coder workflow for Z68.53

MedCoder structured workflow — derived from this code’s own official record

Before you code Z68.53

  1. Confirm the reason for the encounter this Z code records: a status — a condition, carrier state or sequela that may affect care, distinct from a current complication of it. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c.3, I.C.21.c.15).

    Guide: Status codes (Z codes) →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The reason for the encounter
Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age is a billable ICD-10-CM diagnosis code (Z68.53).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Z33.1 Pregnant state, incidental This code is a secondary code only for use when the pregnancy is in no way complicating the reason for visit. Otherwise, a code from the obstetric chapter is required. Z66 Do not resuscitate This code may be used when it is documented by the provider that a patient is on do not resuscitate status at any time during the stay. Z67 Blood type Z68 Body mass index (BMI) BMI codes should only be assigned when there is an associated, reportable diagnosis (such as obesity or anorexia) documented by the patient’s provider. Do not assign BMI codes during pregnancy. When the documentation reflects fluctuating BMI values during the current encounter for an associated reportable condition, assign a code for the most severe value.

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name Z68.53 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 6 Use Additional Code instructions across 3 chapters: E66 — Overweight and obesity (via Z68.5.-), E66 — Overweight and obesity (via Z68.-), E88.82 — Obesity due to disruption of MC4R pathway (via Z68.-), R63.6 — Underweight (via Z68.-), Z15.2 — Genetic susceptibility to obesity (via Z68.-), Z71.3 — Dietary counseling and surveillance (via Z68.-).

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):FAC025 — Other specified status.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified status).

Z68.22 — Body mass index [BMI] 22.0-22.9, adult, Z68.23 — Body mass index [BMI] 23.0-23.9, adult, Z68.24 — Body mass index [BMI] 24.0-24.9, adult, Z68.25 — Body mass index [BMI] 25.0-25.9, adult, Z68.26 — Body mass index [BMI] 26.0-26.9, adult, Z68.27 — Body mass index [BMI] 27.0-27.9, adult, Z68.28 — Body mass index [BMI] 28.0-28.9, adult, Z68.29 — Body mass index [BMI] 29.0-29.9, adult, 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, Z71.1 — Person with feared health complaint in whom no diagnosis is made, Z71.2 — Person consulting for explanation of examination or test findings, Z74.01 — Bed confinement status, Z74.09 — Other reduced mobility, Z74.1 — Need for assistance with personal care, Z74.2 — Need for assistance at home and no other household member able to render care, Z74.3 — Need for continuous supervision, Z74.8 — Other problems related to care provider dependency, Z74.9 — Problem related to care provider dependency, unspecified, Z75.0 — Medical services not available in home, +232 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Body, bodies”; these codes share that main term but sit in a different category of the Tabular List.

A75.2 — Typhus fever due to Rickettsia typhi (Mooser's), F98.4 — Stereotyped movement disorders (rocking), M23.4 — Loose body in knee (rice, knee)

Contextual Map

Every relationship of Z68.53 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Z68.53 with these 5 related codes in Claim Check

Hierarchy

Referenced by Use Additional Code instructions

  • E66 — Overweight and obesity[Use Additional Code](via Z68.5.-): “code to identify body mass index (BMI), if known, for adults (Z68.1-Z68.45) or pediatrics (Z68.5-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • E66 — Overweight and obesity[Use Additional Code](via Z68.-): “code to identify body mass index (BMI), if known, for adults (Z68.1-Z68.45) or pediatrics (Z68.5-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • E88.82 — Obesity due to disruption of MC4R pathway[Use Additional Code](via Z68.-): “code to identify body mass index (BMI), if known (Z68.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • R63.6 — Underweight[Use Additional Code](via Z68.-): “code to identify body mass index (BMI), if known (Z68.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • Z15.2 — Genetic susceptibility to obesity[Use Additional Code](via Z68.-): “code to identify body mass index (BMI), if known (Z68.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • Z71.3 — Dietary counseling and surveillance[Use Additional Code](via Z68.-): “code to identify body mass index (BMI), if known (Z68.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Body, bodies, mass index (BMI), pediatric, 85th percentile to less than 95th percentile for age[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (38)

Change history (3)

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2021 — October 1, 2020
    Description revised
    Body mass index (BMI) pediatric, 85th percentile to less than 95th percentile for age → Body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age
    FY2021 changes
  • FY2021 — October 1, 2020
    Short description revised
    BMI pediatric, 85% to less than 95th percentile for age → Body mass index pediatric, 85% to less than 95% for age
    FY2021 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Body mass index (BMI) pediatric, 85th percentile to less than 95th percentile for age

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z68.53 in its code family, with their registry titles.

View all codes in the Z68 family