HCC 202: Coma, Brain Compression/Anoxic Damage ICD-10-CM
CMS-HCC Category 202 (Coma, Brain Compression/Anoxic Damage) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.097 and 0.721 to a beneficiary's RAF score depending on the payment segment (0.543 for a community, non-dual, aged enrollee). 61 ICD-10-CM diagnosis codes map to HCC 202. A more severe related category (HCC 63, HCC 397, and HCC 398) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.543 |
| Community, partial-benefit dual, aged | 0.549 |
| Community, full-benefit dual, aged | 0.721 |
| Community, non-dual, disabled | 0.238 |
| Community, partial-benefit dual, disabled | 0.309 |
| Community, full-benefit dual, disabled | 0.279 |
| Institutional | 0.097 |
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 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 397 (Major Head Injury with Loss of Consciousness > 1 Hour), and HCC 398 (Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified) supersede HCC 202 when reported together.
ICD-10-CM Codes That Map to HCC 202 61 codes
- E03.5 Myxedema coma from V24 HCC 23
- G93.1 Anoxic brain damage, not elsewhere classified from V24 HCC 80
- G93.5 Compression of brain from V24 HCC 80
- G93.6 Cerebral edema from V24 HCC 80
- P91.0 Neonatal cerebral ischemia new to V28
- P91.1 Acquired periventricular cysts of newborn new to V28
- P91.2 Neonatal cerebral leukomalacia new to V28
- P91.3 Neonatal cerebral irritability new to V28
- P91.4 Neonatal cerebral depression new to V28
- P91.5 Neonatal coma new to V28
- P91.60 Hypoxic ischemic encephalopathy [HIE], unspecified new to V28
- P91.61 Mild hypoxic ischemic encephalopathy [HIE] new to V28
- P91.62 Moderate hypoxic ischemic encephalopathy [HIE] new to V28
- P91.63 Severe hypoxic ischemic encephalopathy [HIE] new to V28
- P91.811 Neonatal encephalopathy in diseases classified elsewhere new to V28
- P91.819 Neonatal encephalopathy, unspecified new to V28
- P91.88 Other specified disturbances of cerebral status of newborn new to V28
- P91.9 Disturbance of cerebral status of newborn, unspecified new to V28
- R40.20 Unspecified coma from V24 HCC 80
- R40.2110 Coma scale, eyes open, never, unspecified time from V24 HCC 80
- R40.2111 Coma scale, eyes open, never, in the field [EMT or ambulance] from V24 HCC 80
- R40.2112 Coma scale, eyes open, never, at arrival to emergency department from V24 HCC 80
- R40.2113 Coma scale, eyes open, never, at hospital admission from V24 HCC 80
- R40.2114 Coma scale, eyes open, never, 24 hours or more after hospital admission from V24 HCC 80
- R40.2120 Coma scale, eyes open, to pain, unspecified time from V24 HCC 80
- R40.2121 Coma scale, eyes open, to pain, in the field [EMT or ambulance] from V24 HCC 80
- R40.2122 Coma scale, eyes open, to pain, at arrival to emergency department from V24 HCC 80
- R40.2123 Coma scale, eyes open, to pain, at hospital admission from V24 HCC 80
- R40.2124 Coma scale, eyes open, to pain, 24 hours or more after hospital admission from V24 HCC 80
- R40.2210 Coma scale, best verbal response, none, unspecified time from V24 HCC 80
- R40.2211 Coma scale, best verbal response, none, in the field [EMT or ambulance] from V24 HCC 80
- R40.2212 Coma scale, best verbal response, none, at arrival to emergency department from V24 HCC 80
- R40.2213 Coma scale, best verbal response, none, at hospital admission from V24 HCC 80
- R40.2214 Coma scale, best verbal response, none, 24 hours or more after hospital admission from V24 HCC 80
- R40.2220 Coma scale, best verbal response, incomprehensible words, unspecified time from V24 HCC 80
- R40.2221 Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance] from V24 HCC 80
- R40.2222 Coma scale, best verbal response, incomprehensible words, at arrival to emergency department from V24 HCC 80
- R40.2223 Coma scale, best verbal response, incomprehensible words, at hospital admission from V24 HCC 80
- R40.2224 Coma scale, best verbal response, incomprehensible words, 24 hours or more after hospital admission from V24 HCC 80
- R40.2310 Coma scale, best motor response, none, unspecified time from V24 HCC 80
- R40.2311 Coma scale, best motor response, none, in the field [EMT or ambulance] from V24 HCC 80
- R40.2312 Coma scale, best motor response, none, at arrival to emergency department from V24 HCC 80
- R40.2313 Coma scale, best motor response, none, at hospital admission from V24 HCC 80
- R40.2314 Coma scale, best motor response, none, 24 hours or more after hospital admission from V24 HCC 80
- R40.2320 Coma scale, best motor response, extension, unspecified time from V24 HCC 80
- R40.2321 Coma scale, best motor response, extension, in the field [EMT or ambulance] from V24 HCC 80
- R40.2322 Coma scale, best motor response, extension, at arrival to emergency department from V24 HCC 80
- R40.2323 Coma scale, best motor response, extension, at hospital admission from V24 HCC 80
- R40.2324 Coma scale, best motor response, extension, 24 hours or more after hospital admission from V24 HCC 80
- R40.2430 Glasgow coma scale score 3-8, unspecified time from V24 HCC 80
- R40.2431 Glasgow coma scale score 3-8, in the field [EMT or ambulance] from V24 HCC 80
- R40.2432 Glasgow coma scale score 3-8, at arrival to emergency department from V24 HCC 80
- R40.2433 Glasgow coma scale score 3-8, at hospital admission from V24 HCC 80
- R40.2434 Glasgow coma scale score 3-8, 24 hours or more after hospital admission from V24 HCC 80
- R40.2440 Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time from V24 HCC 80
- R40.2441 Other coma, without documented Glasgow coma scale score, or with partial score reported, in the field [EMT or ambulance] from V24 HCC 80
- R40.2442 Other coma, without documented Glasgow coma scale score, or with partial score reported, at arrival to emergency department from V24 HCC 80
- R40.2443 Other coma, without documented Glasgow coma scale score, or with partial score reported, at hospital admission from V24 HCC 80
- R40.2444 Other coma, without documented Glasgow coma scale score, or with partial score reported, 24 hours or more after hospital admission from V24 HCC 80
- R40.2A Nontraumatic coma due to underlying condition from V24 HCC 80
- R40.3 Persistent vegetative state from V24 HCC 80
Every code above carries the full HCC 202 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 202
What is HCC 202 in the CMS-HCC model?
HCC 202 is CMS-HCC Category 202 (Coma, Brain Compression/Anoxic Damage) in the V28 risk adjustment model. It covers 61 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 202?
For payment year 2026, HCC 202 adds 0.543 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.097 to 0.721 across the seven payment segments shown above.
Which categories supersede HCC 202?
HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 397 (Major Head Injury with Loss of Consciousness > 1 Hour), and HCC 398 (Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified) sit above HCC 202 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.
