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Z68.45

Z68.45Body mass index [BMI] 70 or greater, adult

Billable / specific codeICD-10-CMPOA exempt

Z68.45 is a billable, specific ICD-10-CM code for body mass index [bmi] 70 or greater, adult. It is valid for submission on a claim.

Risk adjustment

Z68.45 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

  • HCC 48 Morbid Obesity0.186 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

Z68.45 is named in 13 Medicare coverage policies 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A52447Laparoscopic Sleeve Gastrectomy (LSG) – Medical Policy Article
  • A53026Billing and Coding: Bariatric Surgery Coverage
  • A54923Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
  • A56416Billing and Coding: Assays for Vitamins and Metabolic Function

How Z68.45 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z68.45.

  • Body, bodiesmass indexadult70 and over

Related codes at this level

Codes that share Z68.4. If Z68.45 is not quite right, the correct code is usually one of these.

Questions about Z68.45

Is Z68.45 a billable ICD-10-CM code?
Yes. Z68.45 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z68.45 sit in the tabular list?
Factors influencing health status and contact with health services (Z00-Z99), in the block Body mass index [BMI] (Z68).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.