HCC 276: Lung Transplant Status/Complications ICD-10-CM
CMS-HCC Category 276 (Lung Transplant Status/Complications) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 1.277 and 3.085 to a beneficiary's RAF score depending on the payment segment (2.531 for a community, non-dual, aged enrollee). 17 ICD-10-CM diagnosis codes map to HCC 276. It sits at the top of its hierarchy: no other condition category supersedes it.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 2.531 |
| Community, partial-benefit dual, aged | 2.961 |
| Community, full-benefit dual, aged | 2.210 |
| Community, non-dual, disabled | 1.583 |
| Community, partial-benefit dual, disabled | 1.277 |
| Community, full-benefit dual, disabled | 2.292 |
| Institutional | 3.085 |
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. HCC 276 in turn supersedes HCC 277 (Cystic Fibrosis), HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis), HCC 279 (Severe Persistent Asthma), and HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders).
ICD-10-CM Codes That Map to HCC 276 17 codes
- J4A.0 Restrictive allograft syndrome from V24 HCC 186
- J4A.8 Other chronic lung allograft dysfunction from V24 HCC 186
- J4A.9 Chronic lung allograft dysfunction, unspecified from V24 HCC 186
- T86.30 Unspecified complication of heart-lung transplant from V24 HCC 186
- T86.31 Heart-lung transplant rejection from V24 HCC 186
- T86.32 Heart-lung transplant failure from V24 HCC 186
- T86.33 Heart-lung transplant infection from V24 HCC 186
- T86.39 Other complications of heart-lung transplant from V24 HCC 186
- T86.810 Lung transplant rejection from V24 HCC 186
- T86.811 Lung transplant failure from V24 HCC 186
- T86.812 Lung transplant infection from V24 HCC 186
- T86.818 Other complications of lung transplant from V24 HCC 186
- T86.819 Unspecified complication of lung transplant from V24 HCC 186
- Z48.24 Encounter for aftercare following lung transplant from V24 HCC 186
- Z48.280 Encounter for aftercare following heart-lung transplant from V24 HCC 186
- Z94.2 Lung transplant status from V24 HCC 186
- Z94.3 Heart and lungs transplant status from V24 HCC 186
Every code above carries the full HCC 276 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 276
What is HCC 276 in the CMS-HCC model?
HCC 276 is CMS-HCC Category 276 (Lung Transplant Status/Complications) in the V28 risk adjustment model. It covers 17 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 276?
For payment year 2026, HCC 276 adds 2.531 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 1.277 to 3.085 across the seven payment segments shown above.
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.
