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 (living at home, age 65 or over, not also enrolled in Medicaid). 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.
