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221 HCC

Heart Transplant Status/Complications

CMS Model V28 15 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 221)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC221 2026 + 1.412
CFD HCC221 2026 + 1.781
CNA HCC221 2026 + 1.053
CND HCC221 2026 + 0.999
CPA HCC221 2026 + 0.880
CPD HCC221 2026 + 1.371
INS HCC221 2026 + 0.840

Mapped ICD-10-CM Diagnoses (15)

The following diagnoses map directly to HCC 221 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
T86.20 Unspecified complication of heart transplant Notes ↗
T86.21 Heart transplant rejection Notes ↗
T86.22 Heart transplant failure Notes ↗
T86.23 Heart transplant infection Notes ↗
T86.290 Cardiac allograft vasculopathy Notes ↗
T86.298 Other complications of heart transplant Notes ↗
T86.30 Unspecified complication of heart-lung transplant Notes ↗
T86.31 Heart-lung transplant rejection Notes ↗
T86.32 Heart-lung transplant failure Notes ↗
T86.33 Heart-lung transplant infection Notes ↗
T86.39 Other complications of heart-lung transplant Notes ↗
Z48.21 Encounter for aftercare following heart transplant Notes ↗
Z48.280 Encounter for aftercare following heart-lung transplant Notes ↗
Z94.1 Heart transplant status Notes ↗
Z94.3 Heart and lungs transplant status Notes ↗
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