HCC 253: Hemiplegia/Hemiparesis ICD-10-CM
CMS-HCC Category 253 (Hemiplegia/Hemiparesis) 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 0.437 to a beneficiary's RAF score depending on the payment segment (0.387 for a community, non-dual, aged enrollee). 45 ICD-10-CM diagnosis codes map to HCC 253. A more severe related category (HCC 180, HCC 191, and HCC 192) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.387 |
| Community, partial-benefit dual, aged | 0.437 |
| Community, full-benefit dual, aged | 0.437 |
| Community, non-dual, disabled | 0.320 |
| Community, partial-benefit dual, disabled | 0.403 |
| Community, full-benefit dual, disabled | 0.390 |
| 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 180 (Quadriplegia), HCC 191 (Quadriplegic Cerebral Palsy), and HCC 192 (Cerebral Palsy, Except Quadriplegic) supersede HCC 253 when reported together. HCC 253 in turn supersedes HCC 254 (Monoplegia, Other Paralytic Syndromes).
ICD-10-CM Codes That Map to HCC 253 45 codes
- G81.00 Flaccid hemiplegia affecting unspecified side from V24 HCC 103
- G81.01 Flaccid hemiplegia affecting right dominant side from V24 HCC 103
- G81.02 Flaccid hemiplegia affecting left dominant side from V24 HCC 103
- G81.03 Flaccid hemiplegia affecting right nondominant side from V24 HCC 103
- G81.04 Flaccid hemiplegia affecting left nondominant side from V24 HCC 103
- G81.10 Spastic hemiplegia affecting unspecified side from V24 HCC 103
- G81.11 Spastic hemiplegia affecting right dominant side from V24 HCC 103
- G81.12 Spastic hemiplegia affecting left dominant side from V24 HCC 103
- G81.13 Spastic hemiplegia affecting right nondominant side from V24 HCC 103
- G81.14 Spastic hemiplegia affecting left nondominant side from V24 HCC 103
- G81.90 Hemiplegia, unspecified affecting unspecified side from V24 HCC 103
- G81.91 Hemiplegia, unspecified affecting right dominant side from V24 HCC 103
- G81.92 Hemiplegia, unspecified affecting left dominant side from V24 HCC 103
- G81.93 Hemiplegia, unspecified affecting right nondominant side from V24 HCC 103
- G81.94 Hemiplegia, unspecified affecting left nondominant side from V24 HCC 103
- I69.051 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right dominant side from V24 HCC 103
- I69.052 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left dominant side from V24 HCC 103
- I69.053 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side from V24 HCC 103
- I69.054 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side from V24 HCC 103
- I69.059 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting unspecified side from V24 HCC 103
- I69.151 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side from V24 HCC 103
- I69.152 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side from V24 HCC 103
- I69.153 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side from V24 HCC 103
- I69.154 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side from V24 HCC 103
- I69.159 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspecified side from V24 HCC 103
- I69.251 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right dominant side from V24 HCC 103
- I69.252 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left dominant side from V24 HCC 103
- I69.253 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right non-dominant side from V24 HCC 103
- I69.254 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left non-dominant side from V24 HCC 103
- I69.259 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting unspecified side from V24 HCC 103
- I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side from V24 HCC 103
- I69.352 Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side from V24 HCC 103
- I69.353 Hemiplegia and hemiparesis following cerebral infarction affecting right non-dominant side from V24 HCC 103
- I69.354 Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side from V24 HCC 103
- I69.359 Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side from V24 HCC 103
- I69.851 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right dominant side from V24 HCC 103
- I69.852 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left dominant side from V24 HCC 103
- I69.853 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right non-dominant side from V24 HCC 103
- I69.854 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left non-dominant side from V24 HCC 103
- I69.859 Hemiplegia and hemiparesis following other cerebrovascular disease affecting unspecified side from V24 HCC 103
- I69.951 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right dominant side from V24 HCC 103
- I69.952 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left dominant side from V24 HCC 103
- I69.953 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right non-dominant side from V24 HCC 103
- I69.954 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side from V24 HCC 103
- I69.959 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting unspecified side from V24 HCC 103
Every code above carries the full HCC 253 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 253
What is HCC 253 in the CMS-HCC model?
HCC 253 is CMS-HCC Category 253 (Hemiplegia/Hemiparesis) in the V28 risk adjustment model. It covers 45 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 253?
For payment year 2026, HCC 253 adds 0.387 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.000 to 0.437 across the seven payment segments shown above.
Which categories supersede HCC 253?
HCC 180 (Quadriplegia), HCC 191 (Quadriplegic Cerebral Palsy), and HCC 192 (Cerebral Palsy, Except Quadriplegic) sit above HCC 253 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.
