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ICD-10-CM Z73.819: Behavioral insomnia of childhood, unspecified type

Z73.819 is the billable ICD-10-CM code for behavioral insomnia of childhood, unspecified type, in category Z73 (Problems related to life management difficulty) of the Persons encountering health services in other circumstances section. As a principal diagnosis it groups to MS-DRG 951 Other Factors Influencing Health Status (MDC 23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services).

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
Z73.819
billable FY2027 ICD-10-CM code
Category
Z73 Problems related to life management difficulty
Chapter
21: Factors influencing health status and contact with health services (Z00-Z99)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Exempt

Tabular list notes for Z73.819

The tabular list has no notes on Z73.819 itself; the notes below apply from its parent headings.

Inherited from Z73 (Problems related to life management difficulty)

Excludes2 (not part of this condition, may be coded together)
  • problems related to socioeconomic and psychosocial circumstances (Z55-Z65)

MS-DRG grouping when Z73.819 is the principal diagnosis

MS-DRG v44 groups for Z73.819 as principal diagnosis
MDCMS-DRGs
23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services951

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for Z73.819 shows the full grouping logic.

CC/MCC status and inpatient edits

Z73.819 is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check Z73.819 against a principal diagnosis.

  • Present on admission: exempt from POA indicator reporting (FY2027 exempt list).
  • Medicare Code Editor: age conflict: pediatric diagnosis (age 0 to 17); unacceptable principal diagnosis.

CMS-HCC V28 risk adjustment

Z73.819 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

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Frequently asked questions

What does ICD-10-CM Z73.819 mean?

Z73.819 means behavioral insomnia of childhood, unspecified type. It is one of 14 billable codes under Z73, problems related to life management difficulty.

Which MS-DRG does Z73.819 group to?

As the principal diagnosis, Z73.819 groups to MS-DRG 951 Other Factors Influencing Health Status (MDC 23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.