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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.
