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463 HCC

Artificial Openings for Feeding or Elimination

CMS Model V28 41 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 463)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC463 2026 + 0.891
CFD HCC463 2026 + 0.947
CNA HCC463 2026 + 0.673
CND HCC463 2026 + 0.914
CPA HCC463 2026 + 0.526
CPD HCC463 2026 + 0.853
INS HCC463 2026 + 0.634

Mapped ICD-10-CM Diagnoses (41)

The following diagnoses map directly to HCC 463 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
K91.850 Pouchitis Notes ↗
K91.858 Other complications of intestinal pouch Notes ↗
K94.00 Colostomy complication, unspecified Notes ↗
K94.01 Colostomy hemorrhage Notes ↗
K94.02 Colostomy infection Notes ↗
K94.03 Colostomy malfunction Notes ↗
K94.09 Other complications of colostomy Notes ↗
K94.10 Enterostomy complication, unspecified Notes ↗
K94.11 Enterostomy hemorrhage Notes ↗
K94.12 Enterostomy infection Notes ↗
K94.13 Enterostomy malfunction Notes ↗
K94.19 Other complications of enterostomy Notes ↗
K94.20 Gastrostomy complication, unspecified Notes ↗
K94.21 Gastrostomy hemorrhage Notes ↗
K94.22 Gastrostomy infection Notes ↗
K94.23 Gastrostomy malfunction Notes ↗
K94.29 Other complications of gastrostomy Notes ↗
K94.30 Esophagostomy complications, unspecified Notes ↗
K94.31 Esophagostomy hemorrhage Notes ↗
K94.32 Esophagostomy infection Notes ↗
K94.33 Esophagostomy malfunction Notes ↗
K94.39 Other complications of esophagostomy Notes ↗
Z43.1 Encounter for attention to gastrostomy Notes ↗
Z43.2 Encounter for attention to ileostomy Notes ↗
Z43.3 Encounter for attention to colostomy Notes ↗
Z43.4 Encounter for attention to other artificial openings of digestive tract Notes ↗
Z43.5 Encounter for attention to cystostomy Notes ↗
Z43.6 Encounter for attention to other artificial openings of urinary tract Notes ↗
Z43.8 Encounter for attention to other artificial openings Notes ↗
Z43.9 Encounter for attention to unspecified artificial opening Notes ↗
Z93.1 Gastrostomy status Notes ↗
Z93.2 Ileostomy status Notes ↗
Z93.3 Colostomy status Notes ↗
Z93.4 Other artificial openings of gastrointestinal tract status Notes ↗
Z93.50 Unspecified cystostomy status Notes ↗
Z93.51 Cutaneous-vesicostomy status Notes ↗
Z93.52 Appendico-vesicostomy status Notes ↗
Z93.59 Other cystostomy status Notes ↗
Z93.6 Other artificial openings of urinary tract status Notes ↗
Z93.8 Other artificial opening status Notes ↗
Z93.9 Artificial opening status, unspecified Notes ↗
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