HCC 127: Dementia, Mild or Unspecified ICD-10-CM
CMS-HCC Category 127 (Dementia, Mild or Unspecified) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.000 and 0.438 to a beneficiary's RAF score depending on the payment segment (0.341 for a community, non-dual, aged enrollee). 65 ICD-10-CM diagnosis codes map to HCC 127. A more severe related category (HCC 125 and HCC 126) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.341 |
| Community, partial-benefit dual, aged | 0.401 |
| Community, full-benefit dual, aged | 0.438 |
| Community, non-dual, disabled | 0.296 |
| Community, partial-benefit dual, disabled | 0.345 |
| Community, full-benefit dual, disabled | 0.367 |
| Institutional | 0.000 |
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. In the hierarchy, HCC 125 (Dementia, Severe) and HCC 126 (Dementia, Moderate) supersede HCC 127 when reported together.
ICD-10-CM Codes That Map to HCC 127 65 codes
- A81.00 Creutzfeldt-Jakob disease, unspecified from V24 HCC 52
- A81.01 Variant Creutzfeldt-Jakob disease from V24 HCC 52
- A81.09 Other Creutzfeldt-Jakob disease from V24 HCC 52
- A81.1 Subacute sclerosing panencephalitis from V24 HCC 52
- A81.2 Progressive multifocal leukoencephalopathy from V24 HCC 52
- A81.81 Kuru from V24 HCC 52
- A81.82 Gerstmann-Straussler-Scheinker syndrome from V24 HCC 52
- A81.83 Fatal familial insomnia from V24 HCC 52
- A81.89 Other atypical virus infections of central nervous system from V24 HCC 52
- A81.9 Atypical virus infection of central nervous system, unspecified from V24 HCC 52
- F01.50 Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety from V24 HCC 52
- F01.511 Vascular dementia, unspecified severity, with agitation from V24 HCC 51
- F01.518 Vascular dementia, unspecified severity, with other behavioral disturbance from V24 HCC 51
- F01.52 Vascular dementia, unspecified severity, with psychotic disturbance from V24 HCC 51
- F01.53 Vascular dementia, unspecified severity, with mood disturbance from V24 HCC 51
- F01.54 Vascular dementia, unspecified severity, with anxiety from V24 HCC 51
- F01.A0 Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety from V24 HCC 52
- F01.A11 Vascular dementia, mild, with agitation from V24 HCC 51
- F01.A18 Vascular dementia, mild, with other behavioral disturbance from V24 HCC 51
- F01.A2 Vascular dementia, mild, with psychotic disturbance from V24 HCC 51
- F01.A3 Vascular dementia, mild, with mood disturbance from V24 HCC 51
- F01.A4 Vascular dementia, mild, with anxiety from V24 HCC 51
- F02.80 Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety from V24 HCC 52
- F02.811 Dementia in other diseases classified elsewhere, unspecified severity, with agitation from V24 HCC 51
- F02.818 Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance from V24 HCC 51
- F02.82 Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance from V24 HCC 51
- F02.83 Dementia in other diseases classified elsewhere, unspecified severity, with mood disturbance from V24 HCC 51
- F02.84 Dementia in other diseases classified elsewhere, unspecified severity, with anxiety from V24 HCC 51
- F02.A0 Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety from V24 HCC 52
- F02.A11 Dementia in other diseases classified elsewhere, mild, with agitation from V24 HCC 51
- F02.A18 Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance from V24 HCC 51
- F02.A2 Dementia in other diseases classified elsewhere, mild, with psychotic disturbance from V24 HCC 51
- F02.A3 Dementia in other diseases classified elsewhere, mild, with mood disturbance from V24 HCC 51
- F02.A4 Dementia in other diseases classified elsewhere, mild, with anxiety from V24 HCC 51
- F03.90 Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety from V24 HCC 52
- F03.911 Unspecified dementia, unspecified severity, with agitation from V24 HCC 51
- F03.918 Unspecified dementia, unspecified severity, with other behavioral disturbance from V24 HCC 51
- F03.92 Unspecified dementia, unspecified severity, with psychotic disturbance from V24 HCC 51
- F03.93 Unspecified dementia, unspecified severity, with mood disturbance from V24 HCC 51
- F03.94 Unspecified dementia, unspecified severity, with anxiety from V24 HCC 51
- F03.A0 Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety from V24 HCC 52
- F03.A11 Unspecified dementia, mild, with agitation from V24 HCC 51
- F03.A18 Unspecified dementia, mild, with other behavioral disturbance from V24 HCC 51
- F03.A2 Unspecified dementia, mild, with psychotic disturbance from V24 HCC 51
- F03.A3 Unspecified dementia, mild, with mood disturbance from V24 HCC 51
- F03.A4 Unspecified dementia, mild, with anxiety from V24 HCC 51
- G30.0 Alzheimer's disease with early onset from V24 HCC 52
- G30.1 Alzheimer's disease with late onset from V24 HCC 52
- G30.8 Other Alzheimer's disease from V24 HCC 52
- G30.9 Alzheimer's disease, unspecified from V24 HCC 52
- G31.01 Pick's disease from V24 HCC 52
- G31.09 Other frontotemporal neurocognitive disorder from V24 HCC 52
- G31.81 Alpers disease from V24 HCC 52
- G31.82 Leigh's disease from V24 HCC 52
- G31.83 Neurocognitive disorder with Lewy bodies from V24 HCC 52
- G31.86 Alexander disease from V24 HCC 52
- G91.0 Communicating hydrocephalus from V24 HCC 51
- G91.1 Obstructive hydrocephalus from V24 HCC 51
- G91.2 (Idiopathic) normal pressure hydrocephalus from V24 HCC 51
- G91.3 Post-traumatic hydrocephalus, unspecified from V24 HCC 51
- G91.4 Hydrocephalus in diseases classified elsewhere from V24 HCC 51
- G91.8 Other hydrocephalus from V24 HCC 51
- G91.9 Hydrocephalus, unspecified from V24 HCC 51
- G93.7 Reye's syndrome from V24 HCC 52
- I67.3 Progressive vascular leukoencephalopathy from V24 HCC 52
Every code above carries the full HCC 127 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 127
What is HCC 127 in the CMS-HCC model?
HCC 127 is CMS-HCC Category 127 (Dementia, Mild or Unspecified) in the V28 risk adjustment model. It covers 65 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 127?
For payment year 2026, HCC 127 adds 0.341 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.000 to 0.438 across the seven payment segments shown above.
Which categories supersede HCC 127?
HCC 125 (Dementia, Severe) and HCC 126 (Dementia, Moderate) sit above HCC 127 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.
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.
