HCC 279: Severe Persistent Asthma ICD-10-CM
CMS-HCC Category 279 (Severe Persistent Asthma) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.594 and 0.873 to a beneficiary's RAF score depending on the payment segment (0.818 for a community, non-dual, aged enrollee). 3 ICD-10-CM diagnosis codes map to HCC 279. A more severe related category (HCC 276, HCC 277, and HCC 278) 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 | 0.594 |
| Community, non-dual, disabled | 0.842 |
| Community, partial-benefit dual, disabled | 0.804 |
| Community, full-benefit dual, disabled | 0.808 |
| 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), HCC 277 (Cystic Fibrosis), and HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) supersede HCC 279 when reported together. HCC 279 in turn supersedes HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders).
ICD-10-CM Codes That Map to HCC 279 3 codes
- J45.50 Severe persistent asthma, uncomplicated new to V28
- J45.51 Severe persistent asthma with (acute) exacerbation new to V28
- J45.52 Severe persistent asthma with status asthmaticus new to V28
Every code above carries the full HCC 279 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 279
What is HCC 279 in the CMS-HCC model?
HCC 279 is CMS-HCC Category 279 (Severe Persistent Asthma) in the V28 risk adjustment model. It covers 3 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 279?
For payment year 2026, HCC 279 adds 0.818 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.594 to 0.873 across the seven payment segments shown above.
Which categories supersede HCC 279?
HCC 276 (Lung Transplant Status/Complications), HCC 277 (Cystic Fibrosis), and HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) sit above HCC 279 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.
