HCC 19: Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers ICD-10-CM
CMS-HCC Category 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.957 and 1.989 to a beneficiary's RAF score depending on the payment segment (1.798 for a community, non-dual, aged enrollee). 68 ICD-10-CM diagnosis codes map to HCC 19. A more severe related category (HCC 17 and HCC 18) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 1.798 |
| Community, partial-benefit dual, aged | 1.520 |
| Community, full-benefit dual, aged | 1.563 |
| Community, non-dual, disabled | 1.989 |
| Community, partial-benefit dual, disabled | 1.554 |
| Community, full-benefit dual, disabled | 1.661 |
| Institutional | 0.957 |
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 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic) and HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid) supersede HCC 19 when reported together. HCC 19 in turn supersedes HCC 20 (Lung and Other Severe Cancers), HCC 21 (Lymphoma and Other Cancers), HCC 22 (Bladder, Colorectal, and Other Cancers), and HCC 23 (Prostate, Breast, and Other Cancers and Tumors).
ICD-10-CM Codes That Map to HCC 19 68 codes
- C45.0 Mesothelioma of pleura from V24 HCC 9
- C45.1 Mesothelioma of peritoneum from V24 HCC 9
- C45.2 Mesothelioma of pericardium from V24 HCC 9
- C45.7 Mesothelioma of other sites from V24 HCC 9
- C45.9 Mesothelioma, unspecified from V24 HCC 9
- C84.40 Peripheral T-cell lymphoma, not elsewhere classified, unspecified site from V24 HCC 10
- C84.41 Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of head, face, and neck from V24 HCC 10
- C84.42 Peripheral T-cell lymphoma, not elsewhere classified, intrathoracic lymph nodes from V24 HCC 10
- C84.43 Peripheral T-cell lymphoma, not elsewhere classified, intra-abdominal lymph nodes from V24 HCC 10
- C84.44 Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of axilla and upper limb from V24 HCC 10
- C84.45 Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of inguinal region and lower limb from V24 HCC 10
- C84.46 Peripheral T-cell lymphoma, not elsewhere classified, intrapelvic lymph nodes from V24 HCC 10
- C84.47 Peripheral T-cell lymphoma, not elsewhere classified, spleen from V24 HCC 10
- C84.48 Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of multiple sites from V24 HCC 10
- C84.49 Peripheral T-cell lymphoma, not elsewhere classified, extranodal and solid organ sites from V24 HCC 10
- C84.4A Peripheral T-cell lymphoma, not elsewhere classified, in remission from V24 HCC 10
- C84.70 Anaplastic large cell lymphoma, ALK-negative, unspecified site from V24 HCC 10
- C84.71 Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neck from V24 HCC 10
- C84.72 Anaplastic large cell lymphoma, ALK-negative, intrathoracic lymph nodes from V24 HCC 10
- C84.73 Anaplastic large cell lymphoma, ALK-negative, intra-abdominal lymph nodes from V24 HCC 10
- C84.74 Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb from V24 HCC 10
- C84.75 Anaplastic large cell lymphoma, ALK-negative, lymph nodes of inguinal region and lower limb from V24 HCC 10
- C84.76 Anaplastic large cell lymphoma, ALK-negative, intrapelvic lymph nodes from V24 HCC 10
- C84.77 Anaplastic large cell lymphoma, ALK-negative, spleen from V24 HCC 10
- C84.78 Anaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites from V24 HCC 10
- C84.79 Anaplastic large cell lymphoma, ALK-negative, extranodal and solid organ sites from V24 HCC 10
- C84.7A Anaplastic large cell lymphoma, ALK-negative, breast from V24 HCC 10
- C84.7B Anaplastic large cell lymphoma, ALK-negative, in remission from V24 HCC 10
- C86.30 Subcutaneous panniculitis-like T-cell lymphoma not having achieved remission from V24 HCC 10
- C86.31 Subcutaneous panniculitis-like T-cell lymphoma, in remission from V24 HCC 10
- C86.40 Blastic NK-cell lymphoma not having achieved remission from V24 HCC 10
- C86.41 Blastic NK-cell lymphoma, in remission from V24 HCC 10
- C86.50 Angioimmunoblastic T-cell lymphoma not having achieved remission from V24 HCC 10
- C86.51 Angioimmunoblastic T-cell lymphoma, in remission from V24 HCC 10
- C90.00 Multiple myeloma not having achieved remission from V24 HCC 9
- C90.01 Multiple myeloma in remission from V24 HCC 9
- C90.02 Multiple myeloma in relapse from V24 HCC 9
- C90.10 Plasma cell leukemia not having achieved remission from V24 HCC 9
- C90.11 Plasma cell leukemia in remission from V24 HCC 9
- C90.12 Plasma cell leukemia in relapse from V24 HCC 9
- C90.20 Extramedullary plasmacytoma not having achieved remission from V24 HCC 9
- C90.21 Extramedullary plasmacytoma in remission from V24 HCC 9
- C90.22 Extramedullary plasmacytoma in relapse from V24 HCC 9
- C90.30 Solitary plasmacytoma not having achieved remission from V24 HCC 10
- C90.31 Solitary plasmacytoma in remission from V24 HCC 10
- C90.32 Solitary plasmacytoma in relapse from V24 HCC 10
- C91.30 Prolymphocytic leukemia of B-cell type not having achieved remission from V24 HCC 10
- C91.31 Prolymphocytic leukemia of B-cell type, in remission from V24 HCC 10
- C91.32 Prolymphocytic leukemia of B-cell type, in relapse from V24 HCC 10
- C91.50 Adult T-cell lymphoma/leukemia (HTLV-1-associated) not having achieved remission from V24 HCC 10
- C91.51 Adult T-cell lymphoma/leukemia (HTLV-1-associated), in remission from V24 HCC 10
- C91.52 Adult T-cell lymphoma/leukemia (HTLV-1-associated), in relapse from V24 HCC 10
- C91.60 Prolymphocytic leukemia of T-cell type not having achieved remission from V24 HCC 10
- C91.61 Prolymphocytic leukemia of T-cell type, in remission from V24 HCC 10
- C91.62 Prolymphocytic leukemia of T-cell type, in relapse from V24 HCC 10
- C94.6 Myelodysplastic disease, not elsewhere classified from V24 HCC 48
- D46.0 Refractory anemia without ring sideroblasts, so stated from V24 HCC 46
- D46.1 Refractory anemia with ring sideroblasts from V24 HCC 46
- D46.20 Refractory anemia with excess of blasts, unspecified from V24 HCC 46
- D46.21 Refractory anemia with excess of blasts 1 from V24 HCC 46
- D46.4 Refractory anemia, unspecified from V24 HCC 46
- D46.9 Myelodysplastic syndrome, unspecified from V24 HCC 46
- D46.A Refractory cytopenia with multilineage dysplasia from V24 HCC 46
- D46.B Refractory cytopenia with multilineage dysplasia and ring sideroblasts from V24 HCC 46
- D46.C Myelodysplastic syndrome with isolated del(5q) chromosomal abnormality from V24 HCC 46
- D46.Z Other myelodysplastic syndromes from V24 HCC 46
- D47.4 Osteomyelofibrosis from V24 HCC 46
- D75.81 Myelofibrosis from V24 HCC 46
Every code above carries the full HCC 19 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 19
What is HCC 19 in the CMS-HCC model?
HCC 19 is CMS-HCC Category 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) in the V28 risk adjustment model. It covers 68 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 19?
For payment year 2026, HCC 19 adds 1.798 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.957 to 1.989 across the seven payment segments shown above.
Which categories supersede HCC 19?
HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic) and HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid) sit above HCC 19 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.
