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36 HCC

Diabetes with Severe Acute Complications

CMS Model V28 18 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 36)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC36 2026 + 0.186
CFD HCC36 2026 + 0.235
CNA HCC36 2026 + 0.166
CND HCC36 2026 + 0.191
CPA HCC36 2026 + 0.166
CPD HCC36 2026 + 0.210
INS HCC36 2026 + 0.280

Mapped ICD-10-CM Diagnoses (18)

The following diagnoses map directly to HCC 36 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
E08.00 Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) Notes ↗
E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma Notes ↗
E08.10 Diabetes mellitus due to underlying condition with ketoacidosis without coma Notes ↗
E08.11 Diabetes mellitus due to underlying condition with ketoacidosis with coma Notes ↗
E08.641 Diabetes mellitus due to underlying condition with hypoglycemia with coma Notes ↗
E10.10 Type 1 diabetes mellitus with ketoacidosis without coma Notes ↗
E10.11 Type 1 diabetes mellitus with ketoacidosis with coma Notes ↗
E10.641 Type 1 diabetes mellitus with hypoglycemia with coma Notes ↗
E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) Notes ↗
E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma Notes ↗
E11.10 Type 2 diabetes mellitus with ketoacidosis without coma Notes ↗
E11.11 Type 2 diabetes mellitus with ketoacidosis with coma Notes ↗
E11.641 Type 2 diabetes mellitus with hypoglycemia with coma Notes ↗
E13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) Notes ↗
E13.01 Other specified diabetes mellitus with hyperosmolarity with coma Notes ↗
E13.10 Other specified diabetes mellitus with ketoacidosis without coma Notes ↗
E13.11 Other specified diabetes mellitus with ketoacidosis with coma Notes ↗
E13.641 Other specified diabetes mellitus with hypoglycemia with coma Notes ↗
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