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213 HCC

Cardio-Respiratory Failure and Shock

CMS Model V28 36 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 213)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC213 2026 + 0.573
CFD HCC213 2026 + 0.662
CNA HCC213 2026 + 0.370
CND HCC213 2026 + 0.510
CPA HCC213 2026 + 0.409
CPD HCC213 2026 + 0.493
INS HCC213 2026 + 0.258

Mapped ICD-10-CM Diagnoses (36)

The following diagnoses map directly to HCC 213 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
I46.2 Cardiac arrest due to underlying cardiac condition Notes ↗
I46.8 Cardiac arrest due to other underlying condition Notes ↗
I46.9 Cardiac arrest, cause unspecified Notes ↗
I49.01 Ventricular fibrillation Notes ↗
I49.02 Ventricular flutter Notes ↗
J80 Acute respiratory distress syndrome Notes ↗
J81.0 Acute pulmonary edema Notes ↗
J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia Notes ↗
J96.01 Acute respiratory failure with hypoxia Notes ↗
J96.02 Acute respiratory failure with hypercapnia Notes ↗
J96.10 Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia Notes ↗
J96.11 Chronic respiratory failure with hypoxia Notes ↗
J96.12 Chronic respiratory failure with hypercapnia Notes ↗
J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia Notes ↗
J96.21 Acute and chronic respiratory failure with hypoxia Notes ↗
J96.22 Acute and chronic respiratory failure with hypercapnia Notes ↗
J96.90 Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia Notes ↗
J96.91 Respiratory failure, unspecified with hypoxia Notes ↗
J96.92 Respiratory failure, unspecified with hypercapnia Notes ↗
P22.0 Respiratory distress syndrome of newborn Notes ↗
P26.0 Tracheobronchial hemorrhage originating in the perinatal period Notes ↗
P26.1 Massive pulmonary hemorrhage originating in the perinatal period Notes ↗
P26.8 Other pulmonary hemorrhages originating in the perinatal period Notes ↗
P26.9 Unspecified pulmonary hemorrhage originating in the perinatal period Notes ↗
P27.0 Wilson-Mikity syndrome Notes ↗
P27.1 Bronchopulmonary dysplasia originating in the perinatal period Notes ↗
P27.8 Other chronic respiratory diseases originating in the perinatal period Notes ↗
P27.9 Unspecified chronic respiratory disease originating in the perinatal period Notes ↗
P28.0 Primary atelectasis of newborn Notes ↗
P28.10 Unspecified atelectasis of newborn Notes ↗
P28.11 Resorption atelectasis without respiratory distress syndrome Notes ↗
P28.19 Other atelectasis of newborn Notes ↗
P28.5 Respiratory failure of newborn Notes ↗
P29.81 Cardiac arrest of newborn Notes ↗
R57.0 Cardiogenic shock Notes ↗
R57.9 Shock, unspecified Notes ↗
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