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. 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.
