HCC 278: Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis ICD-10-CM
CMS-HCC Category 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.650 and 1.640 to a beneficiary's RAF score depending on the payment segment (0.818 for a community, non-dual, aged enrollee). 4 ICD-10-CM diagnosis codes map to HCC 278. A more severe related category (HCC 276 and HCC 277) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.818 |
| Community, partial-benefit dual, aged | 0.650 |
| Community, full-benefit dual, aged | 0.791 |
| Community, non-dual, disabled | 1.209 |
| Community, partial-benefit dual, disabled | 0.937 |
| Community, full-benefit dual, disabled | 1.640 |
| Institutional | 0.873 |
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 276 (Lung Transplant Status/Complications) and HCC 277 (Cystic Fibrosis) supersede HCC 278 when reported together. HCC 278 in turn supersedes 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 278 4 codes
- J84.112 Idiopathic pulmonary fibrosis from V24 HCC 112
- J84.170 Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere from V24 HCC 112
- M30.1 Polyarteritis with lung involvement [Churg-Strauss] from V24 HCC 40
- M34.81 Systemic sclerosis with lung involvement from V24 HCC 40, HCC 112
Every code above carries the full HCC 278 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 278
What is HCC 278 in the CMS-HCC model?
HCC 278 is CMS-HCC Category 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) in the V28 risk adjustment model. It covers 4 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 278?
For payment year 2026, HCC 278 adds 0.818 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.650 to 1.640 across the seven payment segments shown above.
Which categories supersede HCC 278?
HCC 276 (Lung Transplant Status/Complications) and HCC 277 (Cystic Fibrosis) sit above HCC 278 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.
