HCC 77: Intestine Transplant Status/Complications ICD-10-CM
CMS-HCC Category 77 (Intestine 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 1.172 and 6.301 to a beneficiary's RAF score depending on the payment segment (1.172 for a community, non-dual, aged enrollee). 6 ICD-10-CM diagnosis codes map to HCC 77. 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 | 1.172 |
| Community, partial-benefit dual, aged | 5.039 |
| Community, full-benefit dual, aged | 5.039 |
| Community, non-dual, disabled | 6.301 |
| Community, partial-benefit dual, disabled | 5.039 |
| Community, full-benefit dual, disabled | 6.161 |
| Institutional | 5.089 |
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 77 in turn supersedes HCC 78 (Intestinal Obstruction/Perforation), HCC 80 (Crohn's Disease (Regional Enteritis)), and HCC 81 (Ulcerative Colitis).
ICD-10-CM Codes That Map to HCC 77 6 codes
- T86.850 Intestine transplant rejection from V24 HCC 186
- T86.851 Intestine transplant failure from V24 HCC 186
- T86.852 Intestine transplant infection from V24 HCC 186
- T86.858 Other complications of intestine transplant from V24 HCC 186
- T86.859 Unspecified complication of intestine transplant from V24 HCC 186
- Z94.82 Intestine transplant status from V24 HCC 186
Every code above carries the full HCC 77 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 77
What is HCC 77 in the CMS-HCC model?
HCC 77 is CMS-HCC Category 77 (Intestine Transplant Status/Complications) in the V28 risk adjustment model. It covers 6 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 77?
For payment year 2026, HCC 77 adds 1.172 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 1.172 to 6.301 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.
