This table shows the current list of the CMS HCC codes. It includes the new and updated HCC categories from V23.
The table demonstrates the hierarchy of the categories. For example, if a patient has both metastatic bone cancer (HCC 8) and lung cancer (HCC 9), only the highest code in the hierarchy (HCC 8) will be included in the calculation of the patient’s risk adjustment score.
|Hierarchical Condition Category (HCC)||If the Disease Group is Listed in this column…||…Then drop the Disease Group(s) listed in this column|
|2||Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock|
|8||Metastatic Cancer and Acute Leukemia||9, 10, 11, 12|
|9||Lung and Other Severe Cancers||10, 11, 12|
|10||Lymphoma and Other Cancers||11, 12|
|11||Colorectal, Bladder, and Other Cancers||12|
|12||Breast, Prostate, and Other Cancers and Tumors|
|17||Diabetes with Acute Complications||18, 19|
|18||Diabetes with Chronic Complications||19|