HCC 62: Liver Transplant Status/Complications ICD-10-CM
CMS-HCC Category 62 (Liver Transplant Status/Complications) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.184 and 0.593 to a beneficiary's RAF score depending on the payment segment (0.376 for a community, non-dual, aged enrollee). 7 ICD-10-CM diagnosis codes map to HCC 62. 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 | 0.376 |
| Community, partial-benefit dual, aged | 0.571 |
| Community, full-benefit dual, aged | 0.261 |
| Community, non-dual, disabled | 0.184 |
| Community, partial-benefit dual, disabled | 0.271 |
| Community, full-benefit dual, disabled | 0.409 |
| Institutional | 0.593 |
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 62 in turn supersedes HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 64 (Cirrhosis of Liver), HCC 65 (Chronic Hepatitis), and HCC 68 (Cholangitis and Obstruction of Bile Duct Without Gallstones).
ICD-10-CM Codes That Map to HCC 62 7 codes
- T86.40 Unspecified complication of liver transplant from V24 HCC 186
- T86.41 Liver transplant rejection from V24 HCC 186
- T86.42 Liver transplant failure from V24 HCC 186
- T86.43 Liver transplant infection from V24 HCC 186
- T86.49 Other complications of liver transplant from V24 HCC 186
- Z48.23 Encounter for aftercare following liver transplant from V24 HCC 186
- Z94.4 Liver transplant status from V24 HCC 186
Every code above carries the full HCC 62 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 62
What is HCC 62 in the CMS-HCC model?
HCC 62 is CMS-HCC Category 62 (Liver Transplant Status/Complications) in the V28 risk adjustment model. It covers 7 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 62?
For payment year 2026, HCC 62 adds 0.376 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.184 to 0.593 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.
