Diabetic conditions in V28

These are the HCC categories in CMS-HCC V28.

CMS-HCC v28

HCC 35 Pancreas Transplant Status

HCC 36 Diabetes With Severe Acute Complications (rarely occur in outpatient setting)

HCC 37 Diabetes With Chronic Complications (higher level of severity of illness)

HCC 38 Diabetes With Glycemic, Unspecified, or No Complications

They all provide the same impact to the risk adjustment factor (RAF) score. The previous extra bump in risk adjustment factor for diabetic complications has been removed in this version.

Document linkage of diabetes to any and all manifestations.

2024 payments are based on 2023 dates of service.

Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the date of publication.

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