This table shows the current list of the CMS RxHCC codes.
The table demonstrates the hierarchy of the categories. For example, if a patient has both congestive heart failure (RxHCC 186) and hypertension (RxHCC 187), only the highest code in the hierarchy (RxHCC 186) will be included in the calculation of the patient’s risk adjustment score.
|Rx Hierarchical Condition Category (RxHCC)||If the Disease Group is Listed in this column…||…Then drop the Disease Group(s) listed in this column|
|15||Chronic Myeloid Leukemia||16, 17, 18, 19, 96, 98|
|16||Multiple Myeloma and Other Neoplastic Disorders||17, 18, 19, 96, 98|
|17||Secondary Cancers of Bone, Lung, Brain, and Other Specified Sites; Liver Cancer||18, 19|
|18||Lung, Kidney, and Other Cancers||19|
|19||Breast and Other Cancers and Tumors|
|30||Diabetes with Complications||31|
|31||Diabetes without Complication|
|40||Specified Hereditary Metabolic/Immune Disorders|