HCC 107: Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero ICD-10-CM
CMS-HCC Category 107 (Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.303 and 1.939 to a beneficiary's RAF score depending on the payment segment (0.457 for a community, non-dual, aged enrollee). 14 ICD-10-CM diagnosis codes map to HCC 107. It sits at the top of its hierarchy: no other condition category supersedes it.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.457 |
| Community, partial-benefit dual, aged | 0.303 |
| Community, full-benefit dual, aged | 0.610 |
| Community, non-dual, disabled | 1.449 |
| Community, partial-benefit dual, disabled | 1.569 |
| Community, full-benefit dual, disabled | 1.939 |
| Institutional | 0.692 |
A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. HCC 107 in turn supersedes HCC 108 (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major).
ICD-10-CM Codes That Map to HCC 107 14 codes
- D57.00 Hb-SS disease with crisis, unspecified from V24 HCC 46
- D57.01 Hb-SS disease with acute chest syndrome from V24 HCC 46
- D57.02 Hb-SS disease with splenic sequestration from V24 HCC 46
- D57.03 Hb-SS disease with cerebral vascular involvement from V24 HCC 46
- D57.04 Hb-SS disease with dactylitis from V24 HCC 46
- D57.09 Hb-SS disease with crisis with other specified complication from V24 HCC 46
- D57.1 Sickle-cell disease without crisis from V24 HCC 46
- D57.42 Sickle-cell thalassemia beta zero without crisis from V24 HCC 46
- D57.431 Sickle-cell thalassemia beta zero with acute chest syndrome from V24 HCC 46
- D57.432 Sickle-cell thalassemia beta zero with splenic sequestration from V24 HCC 46
- D57.433 Sickle-cell thalassemia beta zero with cerebral vascular involvement from V24 HCC 46
- D57.434 Sickle-cell thalassemia beta zero with dactylitis from V24 HCC 46
- D57.438 Sickle-cell thalassemia beta zero with crisis with other specified complication from V24 HCC 46
- D57.439 Sickle-cell thalassemia beta zero with crisis, unspecified from V24 HCC 46
Every code above carries the full HCC 107 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.
Questions About HCC 107
What is HCC 107 in the CMS-HCC model?
HCC 107 is CMS-HCC Category 107 (Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero) in the V28 risk adjustment model. It covers 14 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 107?
For payment year 2026, HCC 107 adds 0.457 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.303 to 1.939 across the seven payment segments shown above.
Related References
Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.
