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2 HCC

Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

CMS Model V28 52 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 2)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC2 2026 + 0.649
CFD HCC2 2026 + 0.780
CNA HCC2 2026 + 0.500
CND HCC2 2026 + 0.598
CPA HCC2 2026 + 0.447
CPD HCC2 2026 + 0.591
INS HCC2 2026 + 0.605

Mapped ICD-10-CM Diagnoses (52)

The following diagnoses map directly to HCC 2 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
A02.1 Salmonella sepsis Notes ↗
A20.7 Septicemic plague Notes ↗
A22.7 Anthrax sepsis Notes ↗
A26.7 Erysipelothrix sepsis Notes ↗
A32.7 Listerial sepsis Notes ↗
A39.2 Acute meningococcemia Notes ↗
A39.3 Chronic meningococcemia Notes ↗
A39.4 Meningococcemia, unspecified Notes ↗
A40.0 Sepsis due to streptococcus, group A Notes ↗
A40.1 Sepsis due to streptococcus, group B Notes ↗
A40.3 Sepsis due to Streptococcus pneumoniae Notes ↗
A40.8 Other streptococcal sepsis Notes ↗
A40.9 Streptococcal sepsis, unspecified Notes ↗
A41.01 Sepsis due to Methicillin susceptible Staphylococcus aureus Notes ↗
A41.02 Sepsis due to Methicillin resistant Staphylococcus aureus Notes ↗
A41.1 Sepsis due to other specified staphylococcus Notes ↗
A41.2 Sepsis due to unspecified staphylococcus Notes ↗
A41.3 Sepsis due to Hemophilus influenzae Notes ↗
A41.4 Sepsis due to anaerobes Notes ↗
A41.50 Gram-negative sepsis, unspecified Notes ↗
A41.51 Sepsis due to Escherichia coli [E. coli] Notes ↗
A41.52 Sepsis due to Pseudomonas Notes ↗
A41.53 Sepsis due to Serratia Notes ↗
A41.54 Sepsis due to Acinetobacter baumannii Notes ↗
A41.59 Other Gram-negative sepsis Notes ↗
A41.81 Sepsis due to Enterococcus Notes ↗
A41.89 Other specified sepsis Notes ↗
A41.9 Sepsis, unspecified organism Notes ↗
A42.7 Actinomycotic sepsis Notes ↗
A48.3 Toxic shock syndrome Notes ↗
A54.86 Gonococcal sepsis Notes ↗
B00.7 Disseminated herpesviral disease Notes ↗
B37.7 Candidal sepsis Notes ↗
M35.81 Multisystem inflammatory syndrome Notes ↗
P02.70 Newborn affected by fetal inflammatory response syndrome Notes ↗
P36.0 Sepsis of newborn due to streptococcus, group B Notes ↗
P36.10 Sepsis of newborn due to unspecified streptococci Notes ↗
P36.19 Sepsis of newborn due to other streptococci Notes ↗
P36.2 Sepsis of newborn due to Staphylococcus aureus Notes ↗
P36.30 Sepsis of newborn due to unspecified staphylococci Notes ↗
P36.39 Sepsis of newborn due to other staphylococci Notes ↗
P36.4 Sepsis of newborn due to Escherichia coli Notes ↗
P36.5 Sepsis of newborn due to anaerobes Notes ↗
P36.8 Other bacterial sepsis of newborn Notes ↗
P36.9 Bacterial sepsis of newborn, unspecified Notes ↗
R57.1 Hypovolemic shock Notes ↗
R57.8 Other shock Notes ↗
R65.10 Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction Notes ↗
R65.11 Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction Notes ↗
R65.20 Severe sepsis without septic shock Notes ↗
R65.21 Severe sepsis with septic shock Notes ↗
T79.4XXA Traumatic shock, initial encounter Notes ↗
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