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201 HCC

Seizure Disorders and Convulsions

CMS Model V28 64 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 201)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC201 2026 + 0.233
CFD HCC201 2026 + 0.170
CNA HCC201 2026 + 0.245
CND HCC201 2026 + 0.196
CPA HCC201 2026 + 0.245
CPD HCC201 2026 + 0.202
INS HCC201 2026 + 0.131

Mapped ICD-10-CM Diagnoses (64)

The following diagnoses map directly to HCC 201 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
G40.001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus Notes ↗
G40.009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus Notes ↗
G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus Notes ↗
G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus Notes ↗
G40.101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus Notes ↗
G40.109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus Notes ↗
G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus Notes ↗
G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus Notes ↗
G40.201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus Notes ↗
G40.209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus Notes ↗
G40.211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus Notes ↗
G40.219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus Notes ↗
G40.301 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus Notes ↗
G40.309 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus Notes ↗
G40.311 Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus Notes ↗
G40.319 Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus Notes ↗
G40.401 Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus Notes ↗
G40.409 Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus Notes ↗
G40.411 Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus Notes ↗
G40.419 Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus Notes ↗
G40.42 Cyclin-Dependent Kinase-Like 5 Deficiency Disorder Notes ↗
G40.501 Epileptic seizures related to external causes, not intractable, with status epilepticus Notes ↗
G40.509 Epileptic seizures related to external causes, not intractable, without status epilepticus Notes ↗
G40.801 Other epilepsy, not intractable, with status epilepticus Notes ↗
G40.802 Other epilepsy, not intractable, without status epilepticus Notes ↗
G40.803 Other epilepsy, intractable, with status epilepticus Notes ↗
G40.804 Other epilepsy, intractable, without status epilepticus Notes ↗
G40.811 Lennox-Gastaut syndrome, not intractable, with status epilepticus Notes ↗
G40.812 Lennox-Gastaut syndrome, not intractable, without status epilepticus Notes ↗
G40.813 Lennox-Gastaut syndrome, intractable, with status epilepticus Notes ↗
G40.814 Lennox-Gastaut syndrome, intractable, without status epilepticus Notes ↗
G40.821 Epileptic spasms, not intractable, with status epilepticus Notes ↗
G40.822 Epileptic spasms, not intractable, without status epilepticus Notes ↗
G40.823 Epileptic spasms, intractable, with status epilepticus Notes ↗
G40.824 Epileptic spasms, intractable, without status epilepticus Notes ↗
G40.833 Dravet syndrome, intractable, with status epilepticus Notes ↗
G40.834 Dravet syndrome, intractable, without status epilepticus Notes ↗
G40.841 KCNQ2-related epilepsy, not intractable, with status epilepticus Notes ↗
G40.842 KCNQ2-related epilepsy, not intractable, without status epilepticus Notes ↗
G40.843 KCNQ2-related epilepsy, intractable, with status epilepticus Notes ↗
G40.844 KCNQ2-related epilepsy, intractable, without status epilepticus Notes ↗
G40.89 Other seizures Notes ↗
G40.901 Epilepsy, unspecified, not intractable, with status epilepticus Notes ↗
G40.909 Epilepsy, unspecified, not intractable, without status epilepticus Notes ↗
G40.911 Epilepsy, unspecified, intractable, with status epilepticus Notes ↗
G40.919 Epilepsy, unspecified, intractable, without status epilepticus Notes ↗
G40.A01 Absence epileptic syndrome, not intractable, with status epilepticus Notes ↗
G40.A09 Absence epileptic syndrome, not intractable, without status epilepticus Notes ↗
G40.A11 Absence epileptic syndrome, intractable, with status epilepticus Notes ↗
G40.A19 Absence epileptic syndrome, intractable, without status epilepticus Notes ↗
G40.B01 Juvenile myoclonic epilepsy, not intractable, with status epilepticus Notes ↗
G40.B09 Juvenile myoclonic epilepsy, not intractable, without status epilepticus Notes ↗
G40.B11 Juvenile myoclonic epilepsy, intractable, with status epilepticus Notes ↗
G40.B19 Juvenile myoclonic epilepsy, intractable, without status epilepticus Notes ↗
G40.C01 Lafora progressive myoclonus epilepsy, not intractable, with status epilepticus Notes ↗
G40.C09 Lafora progressive myoclonus epilepsy, not intractable, without status epilepticus Notes ↗
G40.C11 Lafora progressive myoclonus epilepsy, intractable, with status epilepticus Notes ↗
G40.C19 Lafora progressive myoclonus epilepsy, intractable, without status epilepticus Notes ↗
G93.45 Developmental and epileptic encephalopathy Notes ↗
P90 Convulsions of newborn Notes ↗
R56.00 Simple febrile convulsions Notes ↗
R56.01 Complex febrile convulsions Notes ↗
R56.1 Post traumatic seizures Notes ↗
R56.9 Unspecified convulsions Notes ↗
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