HCC 229: Unstable Angina and Other Acute Ischemic Heart Disease ICD-10-CM
CMS-HCC Category 229 (Unstable Angina and Other Acute Ischemic Heart Disease) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.240 and 0.458 to a beneficiary's RAF score depending on the payment segment (0.240 for a community, non-dual, aged enrollee). 25 ICD-10-CM diagnosis codes map to HCC 229. A more severe related category (HCC 228) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.240 |
| Community, partial-benefit dual, aged | 0.278 |
| Community, full-benefit dual, aged | 0.325 |
| Community, non-dual, disabled | 0.254 |
| Community, partial-benefit dual, disabled | 0.315 |
| Community, full-benefit dual, disabled | 0.458 |
| Institutional | 0.310 |
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 228 (Acute Myocardial Infarction) supersedes HCC 229 when reported together.
ICD-10-CM Codes That Map to HCC 229 25 codes
- I20.0 Unstable angina from V24 HCC 87
- I23.0 Hemopericardium as current complication following acute myocardial infarction from V24 HCC 87
- I23.1 Atrial septal defect as current complication following acute myocardial infarction from V24 HCC 87
- I23.2 Ventricular septal defect as current complication following acute myocardial infarction from V24 HCC 87
- I23.3 Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction from V24 HCC 87
- I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction from V24 HCC 86
- I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction from V24 HCC 86
- I23.6 Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction from V24 HCC 87
- I23.7 Postinfarction angina from V24 HCC 87
- I23.8 Other current complications following acute myocardial infarction from V24 HCC 87
- I24.0 Acute coronary thrombosis not resulting in myocardial infarction from V24 HCC 87
- I24.1 Dressler's syndrome from V24 HCC 87
- I24.81 Acute coronary microvascular dysfunction from V24 HCC 87
- I24.89 Other forms of acute ischemic heart disease from V24 HCC 87
- I24.9 Acute ischemic heart disease, unspecified from V24 HCC 87
- I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris from V24 HCC 87
- I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris from V24 HCC 87
- I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris from V24 HCC 87
- I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris from V24 HCC 87
- I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris from V24 HCC 87
- I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina from V24 HCC 87
- I25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina from V24 HCC 87
- I25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris from V24 HCC 87
- I51.1 Rupture of chordae tendineae, not elsewhere classified from V24 HCC 86
- I51.2 Rupture of papillary muscle, not elsewhere classified from V24 HCC 86
Every code above carries the full HCC 229 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 229
What is HCC 229 in the CMS-HCC model?
HCC 229 is CMS-HCC Category 229 (Unstable Angina and Other Acute Ischemic Heart Disease) in the V28 risk adjustment model. It covers 25 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 229?
For payment year 2026, HCC 229 adds 0.240 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.240 to 0.458 across the seven payment segments shown above.
Which categories supersede HCC 229?
HCC 228 (Acute Myocardial Infarction) sits above HCC 229 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.
