HCC 282: Aspiration and Specified Bacterial Pneumonias ICD-10-CM
CMS-HCC Category 282 (Aspiration and Specified Bacterial Pneumonias) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.173 and 0.538 to a beneficiary's RAF score depending on the payment segment (0.440 for a community, non-dual, aged enrollee). 14 ICD-10-CM diagnosis codes map to HCC 282. 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 | 0.440 |
| Community, partial-benefit dual, aged | 0.409 |
| Community, full-benefit dual, aged | 0.538 |
| Community, non-dual, disabled | 0.362 |
| Community, partial-benefit dual, disabled | 0.173 |
| Community, full-benefit dual, disabled | 0.269 |
| Institutional | 0.353 |
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 282 in turn supersedes HCC 283 (Empyema, Lung Abscess).
ICD-10-CM Codes That Map to HCC 282 14 codes
- A48.1 Legionnaires' disease from V24 HCC 114
- J15.0 Pneumonia due to Klebsiella pneumoniae from V24 HCC 114
- J15.1 Pneumonia due to Pseudomonas from V24 HCC 114
- J15.20 Pneumonia due to staphylococcus, unspecified from V24 HCC 114
- J15.211 Pneumonia due to Methicillin susceptible Staphylococcus aureus from V24 HCC 114
- J15.212 Pneumonia due to Methicillin resistant Staphylococcus aureus from V24 HCC 114
- J15.29 Pneumonia due to other staphylococcus from V24 HCC 114
- J15.5 Pneumonia due to Escherichia coli from V24 HCC 114
- J15.61 Pneumonia due to Acinetobacter baumannii from V24 HCC 114
- J15.69 Pneumonia due to other Gram-negative bacteria from V24 HCC 114
- J15.8 Pneumonia due to other specified bacteria from V24 HCC 114
- J69.0 Pneumonitis due to inhalation of food and vomit from V24 HCC 114
- J69.1 Pneumonitis due to inhalation of oils and essences from V24 HCC 114
- J69.8 Pneumonitis due to inhalation of other solids and liquids from V24 HCC 114
Every code above carries the full HCC 282 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 282
What is HCC 282 in the CMS-HCC model?
HCC 282 is CMS-HCC Category 282 (Aspiration and Specified Bacterial Pneumonias) in the V28 risk adjustment model. It covers 14 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 282?
For payment year 2026, HCC 282 adds 0.440 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 0.173 to 0.538 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.
