Menu
226 HCC

Heart Failure, Except End-Stage and Acute

CMS Model V28 34 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 226)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC226 2026 + 0.406
CFD HCC226 2026 + 0.537
CNA HCC226 2026 + 0.360
CND HCC226 2026 + 0.442
CPA HCC226 2026 + 0.311
CPD HCC226 2026 + 0.411
INS HCC226 2026 + 0.217

Mapped ICD-10-CM Diagnoses (34)

The following diagnoses map directly to HCC 226 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
I09.81 Rheumatic heart failure Notes ↗
I11.0 Hypertensive heart disease with heart failure Notes ↗
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease Notes ↗
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease Notes ↗
I27.0 Primary pulmonary hypertension Notes ↗
I27.1 Kyphoscoliotic heart disease Notes ↗
I27.20 Pulmonary hypertension, unspecified Notes ↗
I27.21 Secondary pulmonary arterial hypertension Notes ↗
I27.22 Pulmonary hypertension due to left heart disease Notes ↗
I27.23 Pulmonary hypertension due to lung diseases and hypoxia Notes ↗
I27.24 Chronic thromboembolic pulmonary hypertension Notes ↗
I27.29 Other secondary pulmonary hypertension Notes ↗
I27.81 Cor pulmonale (chronic) Notes ↗
I27.83 Eisenmenger's syndrome Notes ↗
I27.89 Other specified pulmonary heart diseases Notes ↗
I27.9 Pulmonary heart disease, unspecified Notes ↗
I28.0 Arteriovenous fistula of pulmonary vessels Notes ↗
I28.1 Aneurysm of pulmonary artery Notes ↗
I28.8 Other diseases of pulmonary vessels Notes ↗
I28.9 Disease of pulmonary vessels, unspecified Notes ↗
I50.1 Left ventricular failure, unspecified Notes ↗
I50.20 Unspecified systolic (congestive) heart failure Notes ↗
I50.22 Chronic systolic (congestive) heart failure Notes ↗
I50.30 Unspecified diastolic (congestive) heart failure Notes ↗
I50.32 Chronic diastolic (congestive) heart failure Notes ↗
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure Notes ↗
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure Notes ↗
I50.810 Right heart failure, unspecified Notes ↗
I50.812 Chronic right heart failure Notes ↗
I50.814 Right heart failure due to left heart failure Notes ↗
I50.82 Biventricular heart failure Notes ↗
I50.83 High output heart failure Notes ↗
I50.89 Other heart failure Notes ↗
I50.9 Heart failure, unspecified Notes ↗
← Back to V28 Categories Directory