HCC 280: Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders ICD-10-CM
CMS-HCC Category 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.209 and 0.390 to a beneficiary's RAF score depending on the payment segment (0.319 for a community, non-dual, aged enrollee). 79 ICD-10-CM diagnosis codes map to HCC 280. A more severe related category (HCC 276, HCC 277, HCC 278, and HCC 279) supersedes it when both are reported.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.319 |
| Community, partial-benefit dual, aged | 0.321 |
| Community, full-benefit dual, aged | 0.390 |
| Community, non-dual, disabled | 0.209 |
| Community, partial-benefit dual, disabled | 0.234 |
| Community, full-benefit dual, disabled | 0.281 |
| Institutional | 0.312 |
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), HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis), and HCC 279 (Severe Persistent Asthma) supersede HCC 280 when reported together.
ICD-10-CM Codes That Map to HCC 280 79 codes
- B44.81 Allergic bronchopulmonary aspergillosis from V24 HCC 112
- J41.0 Simple chronic bronchitis from V24 HCC 111
- J41.1 Mucopurulent chronic bronchitis from V24 HCC 111
- J41.8 Mixed simple and mucopurulent chronic bronchitis from V24 HCC 111
- J42 Unspecified chronic bronchitis from V24 HCC 111
- J43.0 Unilateral pulmonary emphysema [MacLeod's syndrome] from V24 HCC 111
- J43.1 Panlobular emphysema from V24 HCC 111
- J43.2 Centrilobular emphysema from V24 HCC 111
- J43.8 Other emphysema from V24 HCC 111
- J43.9 Emphysema, unspecified from V24 HCC 111
- J44.0 Chronic obstructive pulmonary disease with (acute) lower respiratory infection from V24 HCC 111
- J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation from V24 HCC 111
- J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome from V24 HCC 111
- J44.89 Other specified chronic obstructive pulmonary disease from V24 HCC 111
- J44.9 Chronic obstructive pulmonary disease, unspecified from V24 HCC 111
- J47.0 Bronchiectasis with acute lower respiratory infection from V24 HCC 112
- J47.1 Bronchiectasis with (acute) exacerbation from V24 HCC 112
- J47.9 Bronchiectasis, uncomplicated from V24 HCC 112
- J60 Coalworker's pneumoconiosis from V24 HCC 112
- J61 Pneumoconiosis due to asbestos and other mineral fibers from V24 HCC 112
- J62.0 Pneumoconiosis due to talc dust from V24 HCC 112
- J62.8 Pneumoconiosis due to other dust containing silica from V24 HCC 112
- J63.0 Aluminosis (of lung) from V24 HCC 112
- J63.1 Bauxite fibrosis (of lung) from V24 HCC 112
- J63.2 Berylliosis from V24 HCC 112
- J63.3 Graphite fibrosis (of lung) from V24 HCC 112
- J63.4 Siderosis from V24 HCC 112
- J63.5 Stannosis from V24 HCC 112
- J63.6 Pneumoconiosis due to other specified inorganic dusts from V24 HCC 112
- J64 Unspecified pneumoconiosis from V24 HCC 112
- J65 Pneumoconiosis associated with tuberculosis from V24 HCC 112
- J66.0 Byssinosis from V24 HCC 112
- J66.1 Flax-dressers' disease from V24 HCC 112
- J66.2 Cannabinosis from V24 HCC 112
- J66.8 Airway disease due to other specific organic dusts from V24 HCC 112
- J67.0 Farmer's lung from V24 HCC 112
- J67.1 Bagassosis from V24 HCC 112
- J67.2 Bird fancier's lung from V24 HCC 112
- J67.3 Suberosis from V24 HCC 112
- J67.4 Maltworker's lung from V24 HCC 112
- J67.5 Mushroom-worker's lung from V24 HCC 112
- J67.6 Maple-bark-stripper's lung from V24 HCC 112
- J67.7 Air conditioner and humidifier lung from V24 HCC 112
- J67.8 Hypersensitivity pneumonitis due to other organic dusts from V24 HCC 112
- J67.9 Hypersensitivity pneumonitis due to unspecified organic dust from V24 HCC 112
- J68.0 Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors from V24 HCC 112
- J68.1 Pulmonary edema due to chemicals, gases, fumes and vapors from V24 HCC 112
- J68.2 Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified from V24 HCC 112
- J68.3 Other acute and subacute respiratory conditions due to chemicals, gases, fumes and vapors from V24 HCC 112
- J68.4 Chronic respiratory conditions due to chemicals, gases, fumes and vapors from V24 HCC 112
- J68.8 Other respiratory conditions due to chemicals, gases, fumes and vapors from V24 HCC 112
- J68.9 Unspecified respiratory condition due to chemicals, gases, fumes and vapors from V24 HCC 112
- J82.81 Chronic eosinophilic pneumonia from V24 HCC 111
- J84.01 Alveolar proteinosis from V24 HCC 112
- J84.02 Pulmonary alveolar microlithiasis from V24 HCC 112
- J84.03 Idiopathic pulmonary hemosiderosis from V24 HCC 112
- J84.09 Other alveolar and parieto-alveolar conditions from V24 HCC 112
- J84.10 Pulmonary fibrosis, unspecified from V24 HCC 112
- J84.111 Idiopathic interstitial pneumonia, not otherwise specified from V24 HCC 112
- J84.113 Idiopathic non-specific interstitial pneumonitis from V24 HCC 112
- J84.114 Acute interstitial pneumonitis from V24 HCC 112
- J84.115 Respiratory bronchiolitis interstitial lung disease from V24 HCC 112
- J84.116 Cryptogenic organizing pneumonia from V24 HCC 112
- J84.117 Desquamative interstitial pneumonia from V24 HCC 112
- J84.178 Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere from V24 HCC 112
- J84.2 Lymphoid interstitial pneumonia from V24 HCC 112
- J84.81 Lymphangioleiomyomatosis from V24 HCC 112
- J84.82 Adult pulmonary Langerhans cell histiocytosis from V24 HCC 112
- J84.89 Other specified interstitial pulmonary diseases from V24 HCC 112
- J84.9 Interstitial pulmonary disease, unspecified from V24 HCC 112
- J98.2 Interstitial emphysema from V24 HCC 111
- J98.3 Compensatory emphysema from V24 HCC 111
- J99 Respiratory disorders in diseases classified elsewhere from V24 HCC 112
- M32.13 Lung involvement in systemic lupus erythematosus from V24 HCC 40, HCC 112
- M33.01 Juvenile dermatomyositis with respiratory involvement from V24 HCC 40, HCC 112
- M33.11 Other dermatomyositis with respiratory involvement from V24 HCC 40, HCC 112
- M33.21 Polymyositis with respiratory involvement from V24 HCC 40, HCC 112
- M33.91 Dermatopolymyositis, unspecified with respiratory involvement from V24 HCC 40, HCC 112
- M35.02 Sjogren syndrome with lung involvement from V24 HCC 40, HCC 112
Every code above carries the full HCC 280 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 280
What is HCC 280 in the CMS-HCC model?
HCC 280 is CMS-HCC Category 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) in the V28 risk adjustment model. It covers 79 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 280?
For payment year 2026, HCC 280 adds 0.319 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.209 to 0.390 across the seven payment segments shown above.
Which categories supersede HCC 280?
HCC 276 (Lung Transplant Status/Complications), HCC 277 (Cystic Fibrosis), HCC 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis), and HCC 279 (Severe Persistent Asthma) sit above HCC 280 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.
