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