HCC 226 (V28)
Heart Failure, Except End-Stage and Acute
34 ICD-10-CM codes map to this category in the CMS-HCC V28 risk adjustment model for payment year 2027. All 115 HCCs
Overridden by: HCC 221 (Heart Transplant Status/Complications), HCC 222 (End-Stage Heart Failure), HCC 223 (Heart Failure with Heart Assist Device/Artificial Heart), HCC 224 (Acute on Chronic Heart Failure), HCC 225 (Acute Heart Failure (Excludes Acute on Chronic)). If the patient also has one of these, only the higher HCC counts.
Overrides: HCC 227 (Cardiomyopathy/Myocarditis).
| I09.81 | Rheumatic heart failure |
| I11.0 | Hypertensive heart disease with heart failure |
| 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 |
| I13.2 | Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease |
| I27.0 | Primary pulmonary hypertension |
| I27.1 | Kyphoscoliotic heart disease |
| I27.20 | Pulmonary hypertension, unspecified |
| I27.21 | Secondary pulmonary arterial hypertension |
| I27.22 | Pulmonary hypertension due to left heart disease |
| I27.23 | Pulmonary hypertension due to lung diseases and hypoxia |
| I27.24 | Chronic thromboembolic pulmonary hypertension |
| I27.29 | Other secondary pulmonary hypertension |
| I27.81 | Cor pulmonale (chronic) |
| I27.83 | Eisenmenger's syndrome |
| I27.89 | Other specified pulmonary heart diseases |
| I27.9 | Pulmonary heart disease, unspecified |
| I28.0 | Arteriovenous fistula of pulmonary vessels |
| I28.1 | Aneurysm of pulmonary artery |
| I28.8 | Other diseases of pulmonary vessels |
| I28.9 | Disease of pulmonary vessels, unspecified |
| I50.1 | Left ventricular failure, unspecified |
| I50.20 | Unspecified systolic (congestive) heart failure |
| I50.22 | Chronic systolic (congestive) heart failure |
| I50.30 | Unspecified diastolic (congestive) heart failure |
| I50.32 | Chronic diastolic (congestive) heart failure |
| I50.40 | Unspecified combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.42 | Chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.810 | Right heart failure, unspecified |
| I50.812 | Chronic right heart failure |
| I50.814 | Right heart failure due to left heart failure |
| I50.82 | Biventricular heart failure |
| I50.83 | High output heart failure |
| I50.89 | Other heart failure |
| I50.9 | Heart failure, unspecified |