CMS-HCC Risk Adjustment · Model Transition V24 → V28
CMS-HCC V24 to V28: What Changed ICD-10-CM
The V28 model restructured Medicare Advantage risk adjustment from 86 payment categories to 115, recalibrated every weight, and rebuilt the diagnosis mappings. Comparing the last paid V24 mappings (payment year 2025) with the live V28 mappings (payment year 2026): 2,267 diagnosis codes no longer risk-adjust, 359 codes newly risk-adjust, and 7,570 codes kept a payment HCC but moved to a different category number. Only 90 codes kept the same number. The table below shows where each V24 category's codes went.
✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026
2,267
No Longer Risk-Adjust
359
Newly Risk-Adjust
7,570
Renumbered
86 → 115
Payment Categories
V24 → V28
Category Crosswalk: Where Each V24 Category's Codes Went 86 V24 categories
86 of 86 shown
Destination chips count each category's surviving codes by their live V28 category; a code mapping to multiple V28 categories counts once per destination. Category numbers link the V24 archive on the left and the live V28 pages on the right.
ICD-10-CM
Codes That Newly Risk-Adjust Under V28 359 codes
Diagnoses with no payment HCC under V24 that map to a live V28 category, including codes new to the ICD-10-CM code set itself.
- C50.A0 Malignant inflammatory neoplasm of unspecified breast now HCC 23
- C50.A1 Malignant inflammatory neoplasm of right breast now HCC 23
- C50.A2 Malignant inflammatory neoplasm of left breast now HCC 23
- D3A.00 Benign carcinoid tumor of unspecified site now HCC 22
- D3A.010 Benign carcinoid tumor of the duodenum now HCC 22
- D3A.011 Benign carcinoid tumor of the jejunum now HCC 22
- D3A.012 Benign carcinoid tumor of the ileum now HCC 22
- D3A.019 Benign carcinoid tumor of the small intestine, unspecified portion now HCC 22
- D3A.020 Benign carcinoid tumor of the appendix now HCC 22
- D3A.021 Benign carcinoid tumor of the cecum now HCC 22
- D3A.022 Benign carcinoid tumor of the ascending colon now HCC 22
- D3A.023 Benign carcinoid tumor of the transverse colon now HCC 22
- D3A.024 Benign carcinoid tumor of the descending colon now HCC 22
- D3A.025 Benign carcinoid tumor of the sigmoid colon now HCC 22
- D3A.026 Benign carcinoid tumor of the rectum now HCC 22
- D3A.029 Benign carcinoid tumor of the large intestine, unspecified portion now HCC 22
- D3A.090 Benign carcinoid tumor of the bronchus and lung now HCC 22
- D3A.091 Benign carcinoid tumor of the thymus now HCC 22
- D3A.092 Benign carcinoid tumor of the stomach now HCC 22
- D3A.093 Benign carcinoid tumor of the kidney now HCC 22
- D3A.094 Benign carcinoid tumor of the foregut, unspecified now HCC 22
- D3A.095 Benign carcinoid tumor of the midgut, unspecified now HCC 22
- D3A.096 Benign carcinoid tumor of the hindgut, unspecified now HCC 22
- D3A.098 Benign carcinoid tumors of other sites now HCC 22
- D3A.8 Other benign neuroendocrine tumors now HCC 22
- D64.4 Congenital dyserythropoietic anemia now HCC 109
- D71.1 Leukocyte adhesion deficiency now HCC 115
- D71.8 Other functional disorders of polymorphonuclear neutrophils now HCC 115
- D71.9 Functional disorders of polymorphonuclear neutrophils, unspecified now HCC 115
- D86.3 Sarcoidosis of skin now HCC 387
- D86.86 Sarcoid arthropathy now HCC 93
- D86.87 Sarcoid myositis now HCC 93
- E72.530 Primary hyperoxaluria, type 1 now HCC 50
- E72.538 Other specified primary hyperoxaluria now HCC 50
- E72.539 Primary hyperoxaluria, unspecified now HCC 50
- E83.00 Disorder of copper metabolism, unspecified now HCC 50
- E83.01 Wilson's disease now HCC 50
- E83.09 Other disorders of copper metabolism now HCC 50
- E83.31 Familial hypophosphatemia now HCC 50
- F50.00 Anorexia nervosa, unspecified now HCC 153
- F50.010 Anorexia nervosa, restricting type, mild now HCC 153
- F50.011 Anorexia nervosa, restricting type, moderate now HCC 153
- F50.012 Anorexia nervosa, restricting type, severe now HCC 153
- F50.013 Anorexia nervosa, restricting type, extreme now HCC 153
- F50.014 Anorexia nervosa, restricting type, in remission now HCC 153
- F50.019 Anorexia nervosa, restricting type, unspecified now HCC 153
- F50.020 Anorexia nervosa, binge eating/purging type, mild now HCC 153
- F50.021 Anorexia nervosa, binge eating/purging type, moderate now HCC 153
- F50.022 Anorexia nervosa, binge eating/purging type, severe now HCC 153
- F50.023 Anorexia nervosa, binge eating/purging type, extreme now HCC 153
- F50.024 Anorexia nervosa, binge eating/purging type, in remission now HCC 153
- F50.029 Anorexia nervosa, binge eating/purging type, unspecified now HCC 153
- F50.20 Bulimia nervosa, unspecified now HCC 153
- F50.21 Bulimia nervosa, mild now HCC 153
- F50.22 Bulimia nervosa, moderate now HCC 153
- F50.23 Bulimia nervosa, severe now HCC 153
- F50.24 Bulimia nervosa, extreme now HCC 153
- F50.25 Bulimia nervosa, in remission now HCC 153
- G14 Postpolio syndrome now HCC 182
- G35.A Relapsing-remitting multiple sclerosis now HCC 198
- G35.B0 Primary progressive multiple sclerosis, unspecified now HCC 198
- G35.B1 Active primary progressive multiple sclerosis now HCC 198
- G35.B2 Non-active primary progressive multiple sclerosis now HCC 198
- G35.C0 Secondary progressive multiple sclerosis, unspecified now HCC 198
- G35.C1 Active secondary progressive multiple sclerosis now HCC 198
- G35.C2 Non-active secondary progressive multiple sclerosis now HCC 198
- G35.D Multiple sclerosis, unspecified now HCC 198
- G71.036 Limb girdle muscular dystrophy due to fukutin related protein dysfunction now HCC 197
- G72.41 Inclusion body myositis [IBM] now HCC 93
- H34.8110 Central retinal vein occlusion, right eye, with macular edema now HCC 298
- H34.8111 Central retinal vein occlusion, right eye, with retinal neovascularization now HCC 298
- H34.8112 Central retinal vein occlusion, right eye, stable now HCC 298
- H34.8120 Central retinal vein occlusion, left eye, with macular edema now HCC 298
- H34.8121 Central retinal vein occlusion, left eye, with retinal neovascularization now HCC 298
- H34.8122 Central retinal vein occlusion, left eye, stable now HCC 298
- H34.8130 Central retinal vein occlusion, bilateral, with macular edema now HCC 298
- H34.8131 Central retinal vein occlusion, bilateral, with retinal neovascularization now HCC 298
- H34.8132 Central retinal vein occlusion, bilateral, stable now HCC 298
- H34.8190 Central retinal vein occlusion, unspecified eye, with macular edema now HCC 298
- H34.8191 Central retinal vein occlusion, unspecified eye, with retinal neovascularization now HCC 298
- H34.8192 Central retinal vein occlusion, unspecified eye, stable now HCC 298
- H34.8310 Tributary (branch) retinal vein occlusion, right eye, with macular edema now HCC 298
- H34.8311 Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization now HCC 298
- H34.8312 Tributary (branch) retinal vein occlusion, right eye, stable now HCC 298
- H34.8320 Tributary (branch) retinal vein occlusion, left eye, with macular edema now HCC 298
- H34.8321 Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization now HCC 298
- H34.8322 Tributary (branch) retinal vein occlusion, left eye, stable now HCC 298
- H34.8330 Tributary (branch) retinal vein occlusion, bilateral, with macular edema now HCC 298
- H34.8331 Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization now HCC 298
- H34.8332 Tributary (branch) retinal vein occlusion, bilateral, stable now HCC 298
- H34.8390 Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema now HCC 298
- H34.8391 Tributary (branch) retinal vein occlusion, unspecified eye, with retinal neovascularization now HCC 298
- H34.8392 Tributary (branch) retinal vein occlusion, unspecified eye, stable now HCC 298
- I31.31 Malignant pericardial effusion in diseases classified elsewhere now HCC 17
- J45.50 Severe persistent asthma, uncomplicated now HCC 279
- J45.51 Severe persistent asthma with (acute) exacerbation now HCC 279
- J45.52 Severe persistent asthma with status asthmaticus now HCC 279
- J91.0 Malignant pleural effusion now HCC 17
- K70.10 Alcoholic hepatitis without ascites now HCC 65
- K70.11 Alcoholic hepatitis with ascites now HCC 65
- K71.3 Toxic liver disease with chronic persistent hepatitis now HCC 65
- K71.4 Toxic liver disease with chronic lobular hepatitis now HCC 65
- K71.50 Toxic liver disease with chronic active hepatitis without ascites now HCC 65
- K71.51 Toxic liver disease with chronic active hepatitis with ascites now HCC 65
- K71.7 Toxic liver disease with fibrosis and cirrhosis of liver now HCC 64
- K83.01 Primary sclerosing cholangitis now HCC 68
- K83.09 Other cholangitis now HCC 68
- K83.1 Obstruction of bile duct now HCC 68
- L10.0 Pemphigus vulgaris now HCC 387
- L10.1 Pemphigus vegetans now HCC 387
- L10.2 Pemphigus foliaceous now HCC 387
- L10.3 Brazilian pemphigus [fogo selvagem] now HCC 387
- L10.4 Pemphigus erythematosus now HCC 387
- L10.81 Paraneoplastic pemphigus now HCC 387
- L10.89 Other pemphigus now HCC 387
- L10.9 Pemphigus, unspecified now HCC 387
- L12.0 Bullous pemphigoid now HCC 387
- L12.1 Cicatricial pemphigoid now HCC 387
- L12.8 Other pemphigoid now HCC 387
- L12.9 Pemphigoid, unspecified now HCC 387
- L88 Pyoderma gangrenosum now HCC 387
- L98.431 Non-pressure chronic ulcer of abdomen limited to breakdown of skin now HCC 383
- L98.432 Non-pressure chronic ulcer of abdomen with fat layer exposed now HCC 383
- L98.433 Non-pressure chronic ulcer of abdomen with necrosis of muscle now HCC 380
- L98.434 Non-pressure chronic ulcer of abdomen with necrosis of bone now HCC 380
- L98.435 Non-pressure chronic ulcer of abdomen with muscle involvement without evidence of necrosis now HCC 380
- L98.436 Non-pressure chronic ulcer of abdomen with bone involvement without evidence of necrosis now HCC 380
- L98.438 Non-pressure chronic ulcer of abdomen with other specified severity now HCC 383
- L98.439 Non-pressure chronic ulcer of abdomen with unspecified severity now HCC 383
- L98.441 Non-pressure chronic ulcer of chest limited to breakdown of skin now HCC 383
- L98.442 Non-pressure chronic ulcer of chest with fat layer exposed now HCC 383
- L98.443 Non-pressure chronic ulcer of chest with necrosis of muscle now HCC 380
- L98.444 Non-pressure chronic ulcer of chest with necrosis of bone now HCC 380
- L98.445 Non-pressure chronic ulcer of chest with muscle involvement without evidence of necrosis now HCC 380
- L98.446 Non-pressure chronic ulcer of chest with bone involvement without evidence of necrosis now HCC 380
- L98.448 Non-pressure chronic ulcer of chest with other specified severity now HCC 383
- L98.449 Non-pressure chronic ulcer of chest with unspecified severity now HCC 383
- L98.451 Non-pressure chronic ulcer of neck limited to breakdown of skin now HCC 383
- L98.452 Non-pressure chronic ulcer of neck with fat layer exposed now HCC 383
- L98.453 Non-pressure chronic ulcer of neck with necrosis of muscle now HCC 380
- L98.454 Non-pressure chronic ulcer of neck with necrosis of bone now HCC 380
- L98.455 Non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis now HCC 380
- L98.456 Non-pressure chronic ulcer of neck with bone involvement without evidence of necrosis now HCC 380
- L98.458 Non-pressure chronic ulcer of neck with other specified severity now HCC 383
- L98.459 Non-pressure chronic ulcer of neck with unspecified severity now HCC 383
- L98.461 Non-pressure chronic ulcer of face limited to breakdown of skin now HCC 383
- L98.462 Non-pressure chronic ulcer of face with fat layer exposed now HCC 383
- L98.463 Non-pressure chronic ulcer of face with necrosis of muscle now HCC 380
- L98.464 Non-pressure chronic ulcer of face with necrosis of bone now HCC 380
- L98.465 Non-pressure chronic ulcer of face with muscle involvement without evidence of necrosis now HCC 380
- L98.466 Non-pressure chronic ulcer of face with bone involvement without evidence of necrosis now HCC 380
- L98.468 Non-pressure chronic ulcer of face with other specified severity now HCC 383
- L98.469 Non-pressure chronic ulcer of face with unspecified severity now HCC 383
- L98.471 Non-pressure chronic ulcer of groin limited to breakdown of skin now HCC 383
- L98.472 Non-pressure chronic ulcer of groin with fat layer exposed now HCC 383
- L98.473 Non-pressure chronic ulcer of groin with necrosis of muscle now HCC 380
- L98.474 Non-pressure chronic ulcer of groin with necrosis of bone now HCC 380
- L98.475 Non-pressure chronic ulcer of groin with muscle involvement without evidence of necrosis now HCC 380
- L98.476 Non-pressure chronic ulcer of groin with bone involvement without evidence of necrosis now HCC 380
- L98.478 Non-pressure chronic ulcer of groin with other specified severity now HCC 383
- L98.479 Non-pressure chronic ulcer of groin with unspecified severity now HCC 383
- L98.A111 Non-pressure chronic ulcer of right upper arm limited to breakdown of skin now HCC 383
- L98.A112 Non-pressure chronic ulcer of right upper arm with fat layer exposed now HCC 383
- L98.A113 Non-pressure chronic ulcer of right upper arm with necrosis of muscle now HCC 380
- L98.A114 Non-pressure chronic ulcer of right upper arm with necrosis of bone now HCC 380
- L98.A115 Non-pressure chronic ulcer of right upper arm with muscle involvement without evidence of necrosis now HCC 380
- L98.A116 Non-pressure chronic ulcer of right upper arm with bone involvement without evidence of necrosis now HCC 380
- L98.A118 Non-pressure chronic ulcer of right upper arm with other specified severity now HCC 383
- L98.A119 Non-pressure chronic ulcer of right upper arm with unspecified severity now HCC 383
- L98.A121 Non-pressure chronic ulcer of left upper arm limited to breakdown of skin now HCC 383
- L98.A122 Non-pressure chronic ulcer of left upper arm with fat layer exposed now HCC 383
- L98.A123 Non-pressure chronic ulcer of left upper arm with necrosis of muscle now HCC 380
- L98.A124 Non-pressure chronic ulcer of left upper arm with necrosis of bone now HCC 380
- L98.A125 Non-pressure chronic ulcer of left upper arm with muscle involvement without evidence of necrosis now HCC 380
- L98.A126 Non-pressure chronic ulcer of left upper arm with bone involvement without evidence of necrosis now HCC 380
- L98.A128 Non-pressure chronic ulcer of left upper arm with other specified severity now HCC 383
- L98.A129 Non-pressure chronic ulcer of left upper arm with unspecified severity now HCC 383
- L98.A191 Non-pressure chronic ulcer of unspecified upper arm limited to breakdown of skin now HCC 383
- L98.A192 Non-pressure chronic ulcer of unspecified upper arm with fat layer exposed now HCC 383
- L98.A193 Non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle now HCC 380
- L98.A194 Non-pressure chronic ulcer of unspecified upper arm with necrosis of bone now HCC 380
- L98.A195 Non-pressure chronic ulcer of unspecified upper arm with muscle involvement without evidence of necrosis now HCC 380
- L98.A196 Non-pressure chronic ulcer of unspecified upper arm with bone involvement without evidence of necrosis now HCC 380
- L98.A198 Non-pressure chronic ulcer of unspecified upper arm with other specified severity now HCC 383
- L98.A199 Non-pressure chronic ulcer of unspecified upper arm with unspecified severity now HCC 383
- L98.A211 Non-pressure chronic ulcer of right forearm limited to breakdown of skin now HCC 383
- L98.A212 Non-pressure chronic ulcer of right forearm with fat layer exposed now HCC 383
- L98.A213 Non-pressure chronic ulcer of right forearm with necrosis of muscle now HCC 380
- L98.A214 Non-pressure chronic ulcer of right forearm with necrosis of bone now HCC 380
- L98.A215 Non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis now HCC 380
- L98.A216 Non-pressure chronic ulcer of right forearm with bone involvement without evidence of necrosis now HCC 380
- L98.A218 Non-pressure chronic ulcer of right forearm with other specified severity now HCC 383
- L98.A219 Non-pressure chronic ulcer of right forearm with unspecified severity now HCC 383
- L98.A221 Non-pressure chronic ulcer of left forearm limited to breakdown of skin now HCC 383
- L98.A222 Non-pressure chronic ulcer of left forearm with fat layer exposed now HCC 383
- L98.A223 Non-pressure chronic ulcer of left forearm with necrosis of muscle now HCC 380
- L98.A224 Non-pressure chronic ulcer of left forearm with necrosis of bone now HCC 380
- L98.A225 Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis now HCC 380
- L98.A226 Non-pressure chronic ulcer of left forearm with bone involvement without evidence of necrosis now HCC 380
- L98.A228 Non-pressure chronic ulcer of left forearm with other specified severity now HCC 383
- L98.A229 Non-pressure chronic ulcer of left forearm with unspecified severity now HCC 383
- L98.A291 Non-pressure chronic ulcer of unspecified forearm limited to breakdown of skin now HCC 383
- L98.A292 Non-pressure chronic ulcer of unspecified forearm with fat layer exposed now HCC 383
- L98.A293 Non-pressure chronic ulcer of unspecified forearm with necrosis of muscle now HCC 380
- L98.A294 Non-pressure chronic ulcer of unspecified forearm with necrosis of bone now HCC 380
- L98.A295 Non-pressure chronic ulcer of unspecified forearm with muscle involvement without evidence of necrosis now HCC 380
- L98.A296 Non-pressure chronic ulcer of unspecified forearm with bone involvement without evidence of necrosis now HCC 380
- L98.A298 Non-pressure chronic ulcer of unspecified forearm with other specified severity now HCC 383
- L98.A299 Non-pressure chronic ulcer of unspecified forearm with unspecified severity now HCC 383
- L98.A311 Non-pressure chronic ulcer of right hand limited to breakdown of skin now HCC 383
- L98.A312 Non-pressure chronic ulcer of right hand with fat layer exposed now HCC 383
- L98.A313 Non-pressure chronic ulcer of right hand with necrosis of muscle now HCC 380
- L98.A314 Non-pressure chronic ulcer of right hand with necrosis of bone now HCC 380
- L98.A315 Non-pressure chronic ulcer of right hand with muscle involvement without evidence of necrosis now HCC 380
- L98.A316 Non-pressure chronic ulcer of right hand with bone involvement without evidence of necrosis now HCC 380
- L98.A318 Non-pressure chronic ulcer of right hand with other specified severity now HCC 383
- L98.A319 Non-pressure chronic ulcer of right hand with unspecified severity now HCC 383
- L98.A321 Non-pressure chronic ulcer of left hand limited to breakdown of skin now HCC 383
- L98.A322 Non-pressure chronic ulcer of left hand with fat layer exposed now HCC 383
- L98.A323 Non-pressure chronic ulcer of left hand with necrosis of muscle now HCC 380
- L98.A324 Non-pressure chronic ulcer of left hand with necrosis of bone now HCC 380
- L98.A325 Non-pressure chronic ulcer of left hand with muscle involvement without evidence of necrosis now HCC 380
- L98.A326 Non-pressure chronic ulcer of left hand with bone involvement without evidence of necrosis now HCC 380
- L98.A328 Non-pressure chronic ulcer of left hand with other specified severity now HCC 383
- L98.A329 Non-pressure chronic ulcer of left hand with unspecified severity now HCC 383
- L98.A391 Non-pressure chronic ulcer of unspecified hand limited to breakdown of skin now HCC 383
- L98.A392 Non-pressure chronic ulcer of unspecified hand with fat layer exposed now HCC 383
- L98.A393 Non-pressure chronic ulcer of unspecified hand with necrosis of muscle now HCC 380
- L98.A394 Non-pressure chronic ulcer of unspecified hand with necrosis of bone now HCC 380
- L98.A395 Non-pressure chronic ulcer of unspecified hand with muscle involvement without evidence of necrosis now HCC 380
- L98.A396 Non-pressure chronic ulcer of unspecified hand with bone involvement without evidence of necrosis now HCC 380
- L98.A398 Non-pressure chronic ulcer of unspecified hand with other specified severity now HCC 383
- L98.A399 Non-pressure chronic ulcer of unspecified hand with unspecified severity now HCC 383
- M05.A Abnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis now HCC 93
- N49.3 Fournier gangrene now HCC 92
- P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery now HCC 137
- P04.11 Newborn affected by maternal antineoplastic chemotherapy now HCC 137
- P04.12 Newborn affected by maternal cytotoxic drugs now HCC 137
- P04.13 Newborn affected by maternal use of anticonvulsants now HCC 137
- P04.14 Newborn affected by maternal use of opiates now HCC 137
- P04.15 Newborn affected by maternal use of antidepressants now HCC 137
- P04.16 Newborn affected by maternal use of amphetamines now HCC 137
- P04.17 Newborn affected by maternal use of sedative-hypnotics now HCC 137
- P04.18 Newborn affected by other maternal medication now HCC 137
- P04.19 Newborn affected by maternal use of unspecified medication now HCC 137
- P04.1A Newborn affected by maternal use of anxiolytics now HCC 137
- P04.2 Newborn affected by maternal use of tobacco now HCC 137
- P04.3 Newborn affected by maternal use of alcohol now HCC 137
- P04.40 Newborn affected by maternal use of unspecified drugs of addiction now HCC 137
- P04.41 Newborn affected by maternal use of cocaine now HCC 137
- P04.42 Newborn affected by maternal use of hallucinogens now HCC 137
- P04.49 Newborn affected by maternal use of other drugs of addiction now HCC 137
- P04.5 Newborn affected by maternal use of nutritional chemical substances now HCC 137
- P04.6 Newborn affected by maternal exposure to environmental chemical substances now HCC 137
- P04.81 Newborn affected by maternal use of cannabis now HCC 137
- P04.89 Newborn affected by other maternal noxious substances now HCC 137
- P04.9 Newborn affected by maternal noxious substance, unspecified now HCC 137
- P10.0 Subdural hemorrhage due to birth injury now HCC 248
- P10.1 Cerebral hemorrhage due to birth injury now HCC 248
- P10.2 Intraventricular hemorrhage due to birth injury now HCC 248
- P10.3 Subarachnoid hemorrhage due to birth injury now HCC 248
- P10.4 Tentorial tear due to birth injury now HCC 248
- P10.8 Other intracranial lacerations and hemorrhages due to birth injury now HCC 248
- P10.9 Unspecified intracranial laceration and hemorrhage due to birth injury now HCC 248
- P11.0 Cerebral edema due to birth injury now HCC 248
- P11.1 Other specified brain damage due to birth injury now HCC 248
- P11.2 Unspecified brain damage due to birth injury now HCC 248
- P11.5 Birth injury to spine and spinal cord now HCC 182
- P12.2 Epicranial subaponeurotic hemorrhage due to birth injury now HCC 399
- P22.0 Respiratory distress syndrome of newborn now HCC 213
- P26.0 Tracheobronchial hemorrhage originating in the perinatal period now HCC 213
- P26.1 Massive pulmonary hemorrhage originating in the perinatal period now HCC 213
- P26.8 Other pulmonary hemorrhages originating in the perinatal period now HCC 213
- P26.9 Unspecified pulmonary hemorrhage originating in the perinatal period now HCC 213
- P27.0 Wilson-Mikity syndrome now HCC 213
- P27.1 Bronchopulmonary dysplasia originating in the perinatal period now HCC 213
- P27.8 Other chronic respiratory diseases originating in the perinatal period now HCC 213
- P27.9 Unspecified chronic respiratory disease originating in the perinatal period now HCC 213
- P28.0 Primary atelectasis of newborn now HCC 213
- P28.10 Unspecified atelectasis of newborn now HCC 213
- P28.11 Resorption atelectasis without respiratory distress syndrome now HCC 213
- P28.19 Other atelectasis of newborn now HCC 213
- P28.5 Respiratory failure of newborn now HCC 213
- P28.81 Respiratory arrest of newborn now HCC 212
- P29.0 Neonatal cardiac failure now HCC 225
- P29.81 Cardiac arrest of newborn now HCC 213
- P52.0 Intraventricular (nontraumatic) hemorrhage, grade 1, of newborn now HCC 248
- P52.1 Intraventricular (nontraumatic) hemorrhage, grade 2, of newborn now HCC 248
- P52.21 Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn now HCC 248
- P52.22 Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn now HCC 248
- P52.3 Unspecified intraventricular (nontraumatic) hemorrhage of newborn now HCC 248
- P52.4 Intracerebral (nontraumatic) hemorrhage of newborn now HCC 248
- P52.5 Subarachnoid (nontraumatic) hemorrhage of newborn now HCC 248
- P52.6 Cerebellar (nontraumatic) and posterior fossa hemorrhage of newborn now HCC 248
- P52.8 Other intracranial (nontraumatic) hemorrhages of newborn now HCC 248
- P52.9 Intracranial (nontraumatic) hemorrhage of newborn, unspecified now HCC 248
- P55.0 Rh isoimmunization of newborn now HCC 109
- P55.1 ABO isoimmunization of newborn now HCC 109
- P55.8 Other hemolytic diseases of newborn now HCC 109
- P55.9 Hemolytic disease of newborn, unspecified now HCC 109
- P56.0 Hydrops fetalis due to isoimmunization now HCC 109
- P56.90 Hydrops fetalis due to unspecified hemolytic disease now HCC 109
- P56.99 Hydrops fetalis due to other hemolytic disease now HCC 109
- P57.0 Kernicterus due to isoimmunization now HCC 192
- P57.8 Other specified kernicterus now HCC 192
- P57.9 Kernicterus, unspecified now HCC 192
- P77.1 Stage 1 necrotizing enterocolitis in newborn now HCC 78
- P77.2 Stage 2 necrotizing enterocolitis in newborn now HCC 78
- P77.3 Stage 3 necrotizing enterocolitis in newborn now HCC 78
- P77.9 Necrotizing enterocolitis in newborn, unspecified now HCC 78
- P78.0 Perinatal intestinal perforation now HCC 78
- P90 Convulsions of newborn now HCC 201
- P91.0 Neonatal cerebral ischemia now HCC 202
- P91.1 Acquired periventricular cysts of newborn now HCC 202
- P91.2 Neonatal cerebral leukomalacia now HCC 202
- P91.3 Neonatal cerebral irritability now HCC 202
- P91.4 Neonatal cerebral depression now HCC 202
- P91.5 Neonatal coma now HCC 202
- P91.60 Hypoxic ischemic encephalopathy [HIE], unspecified now HCC 202
- P91.61 Mild hypoxic ischemic encephalopathy [HIE] now HCC 202
- P91.62 Moderate hypoxic ischemic encephalopathy [HIE] now HCC 202
- P91.63 Severe hypoxic ischemic encephalopathy [HIE] now HCC 202
- P91.811 Neonatal encephalopathy in diseases classified elsewhere now HCC 202
- P91.819 Neonatal encephalopathy, unspecified now HCC 202
- P91.88 Other specified disturbances of cerebral status of newborn now HCC 202
- P91.9 Disturbance of cerebral status of newborn, unspecified now HCC 202
- P93.0 Grey baby syndrome now HCC 137
- P93.8 Other reactions and intoxications due to drugs administered to newborn now HCC 137
- P96.1 Neonatal withdrawal symptoms from maternal use of drugs of addiction now HCC 137
- P96.2 Withdrawal symptoms from therapeutic use of drugs in newborn now HCC 137
- Q40.0 Congenital hypertrophic pyloric stenosis now HCC 78
- Q41.0 Congenital absence, atresia and stenosis of duodenum now HCC 78
- Q41.1 Congenital absence, atresia and stenosis of jejunum now HCC 78
- Q41.2 Congenital absence, atresia and stenosis of ileum now HCC 78
- Q41.8 Congenital absence, atresia and stenosis of other specified parts of small intestine now HCC 78
- Q41.9 Congenital absence, atresia and stenosis of small intestine, part unspecified now HCC 78
- Q42.0 Congenital absence, atresia and stenosis of rectum with fistula now HCC 78
- Q42.1 Congenital absence, atresia and stenosis of rectum without fistula now HCC 78
- Q42.2 Congenital absence, atresia and stenosis of anus with fistula now HCC 78
- Q42.3 Congenital absence, atresia and stenosis of anus without fistula now HCC 78
- Q42.8 Congenital absence, atresia and stenosis of other parts of large intestine now HCC 78
- Q42.9 Congenital absence, atresia and stenosis of large intestine, part unspecified now HCC 78
- Q43.1 Hirschsprung's disease now HCC 78
- Q43.2 Other congenital functional disorders of colon now HCC 78
- Q43.3 Congenital malformations of intestinal fixation now HCC 78
- Q44.2 Atresia of bile ducts now HCC 68
- Q44.3 Congenital stenosis and stricture of bile ducts now HCC 68
- Q44.71 Alagille syndrome now HCC 68
- R11.16 Cannabis hyperemesis syndrome now HCC 137
- R18.0 Malignant ascites now HCC 17
- T36.AX2A Poisoning by fluoroquinolone antibiotics, intentional self-harm, initial encounter now HCC 155
- T65.842A Toxic effect of xylazine, intentional self-harm, initial encounter now HCC 155
- T82.512A Breakdown (mechanical) of artificial heart, initial encounter now HCC 223
- T82.522A Displacement of artificial heart, initial encounter now HCC 223
- T82.532A Leakage of artificial heart, initial encounter now HCC 223
- T82.592A Other mechanical complication of artificial heart, initial encounter now HCC 223
- Z97.13 Presence of artificial right leg (complete) (partial) now HCC 409
- Z97.14 Presence of artificial left leg (complete) (partial) now HCC 409
- Z97.16 Presence of artificial legs, bilateral (complete) (partial) now HCC 409
Questions About the Transition
Why did CMS replace V24 with V28?
V28 is calibrated on newer cost data and, unlike V24, was built directly on ICD-10 diagnoses rather than mapped forward from ICD-9 groupings. CMS also constrained several coding-variation-prone categories. The result is more categories (115 against 86), renumbered throughout, with fewer diagnosis codes mapping overall.
When did V28 take full effect?
Payment blended the two models during the 2024 and 2025 payment years and V28 determines 100% of the Medicare Advantage risk score from payment year 2026. V24 remains relevant only for lookback and audit periods that predate the transition.
Where is the full list of codes that lost their HCC?
All 2,267 diagnoses that risk-adjusted under V24 but map to no V28 payment category are listed, grouped by chapter and filterable, on Codes That No Longer Risk-Adjust.
Official Sources
- CMS Risk Adjustment ICD-10-CM MappingsThe category tables and every code-to-HCC mapping on ICD List come from the published mapping files.
- CMS-HCC Model SoftwareSource of all RAF weights, category labels, and hierarchy rules, including the PACE, ESRD, and RxHCC models.
ICD List is not affiliated with CMS. This page is a coding and payment reference, not medical or actuarial advice.
Related References
Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28; CMS-HCC V24 from the last published V24 mappings, payment year 2025), applied to the FY 2026 ICD-10-CM code set.
