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