What does HCC stand for in medical coding?

HCC stands for Hierarchical Condition Category. CMS uses HCC risk adjustment to estimate expected medical cost for Medicare Advantage members based on the diagnoses a provider reports during the year (CMS Risk Adjustment program: https://www.cms.gov/medicare/health-plans/medicareadvtgspecratestats/risk-adjustors).

What is the difference between HCC model V24 and V28?

V28 is the CMS-HCC model that began phasing in for payment year 2024 and reached 100% phase-in for payment year 2026. Compared to V24, V28 expands from 86 to 115 payment HCCs, removes some lower-acuity diagnosis groups, and updates RAF coefficients to reflect ICD-10-CM clinical revisions. Full details are in the CMS 2024 Advance Notice (https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/announcements-and-documents).

What is a RAF score and why does it matter?

Risk Adjustment Factor (RAF) is the numeric coefficient CMS publishes for each payment HCC. The sum of a member's HCC coefficients (plus demographic factors) drives the per-member-per-month payment a Medicare Advantage plan receives. HCC Buddy shows the V28 and V24 RAF coefficients beside each ICD-10 code so coders see risk-adjustment impact without leaving the code card. Source coefficients: CMS RA Model Output (https://www.cms.gov/medicare/health-plans/medicareadvtgspecratestats/risk-adjustors).

What does the HCC Buddy Evidence Checker do?

Evidence Checker reviews deidentified chart wording against MEAT criteria (Monitor, Evaluate, Assess, Treat) and flags documentation gaps, conflicting language, and strength-of-evidence concerns so coders can separate diagnoses that simply have an ICD-10 mapping from diagnoses that are actually supported for risk adjustment under CMS audit standards.

How many ICD-10-CM codes map to HCC categories?

The FY2026 ICD-10-CM tabular list contains roughly 72,000 codes (CMS FY2026 release: https://www.cms.gov/medicare/coding-billing/icd-10-codes), of which about 9,500 map to a CMS-HCC V28 payment category. HCC Buddy shows the HCC value, model version, and source period for each billable code.

Is HCC Buddy free to try?

Yes. Every new account starts with a 14-day Pro trial with full access and no credit card required. Pro is $19.99/month for founding members while spots are open, then $29.99/month after the founding quota is filled. The annual plan is $199.99/year.

Can I paste patient notes into Ask Buddy?

No, and you do not need to. HCC Buddy is built around a Zero PHI posture. Member identifiers, dates of birth, and other patient identifiers are scanned and rejected before any query reaches our servers, and nothing about the chart is stored or transmitted in identifiable form. Coders work from deidentified wording, code numbers, and clinical concepts only, which keeps every workflow compliant on any network.

HCC Buddy

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ICD-10-CM Encoder with HCC Mapping. Every HCC. One search.

Search a code and keep HCC mapping, RAF values, V24 and V28 model context, MEAT support, and source details in one coder-facing encoder. Zero PHI stored or transmitted, ever.

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J44.9 chronic obstructive pulmonary disease

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Monitor, Evaluate, Assess, Treat

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Buddy follows the code path from HCC values to documentation gaps and MEAT support.

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupJ44.9Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Chronic lower respiratory diseases (J40-J4A)

J44.9

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Chronic obstructive pulmonary disease, unspecified

A chronic lung disease (COPD) that causes airflow obstruction and breathing difficulty, but the specific type or characteristics are not documented.

Buddy Insight

Chronic obstructive pulmonary disease, unspecified is the most commonly used COPD code, representing stable COPD without acute exacerbation or infection.

CMS-HCC V28

Mapped

HCC 280

Chronic Obstructive Pulmonary...

RAF 0.334

CMS-HCC V24

Mapped

HCC 111

Chronic Obstructive Pulmonary...

RAF 0.334

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 229

COPD and Chronic Bronchitis

RAF 0.0

Code Trumping

Basket needed

Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

J44Other chronic obstructive pulmonary disease

J44.9Chronic obstructive pulmonary disease, unspecified

Inclusion Terms

Official

Chronic obstructive airway disease NOS
Chronic obstructive lung disease NOS

Excludes 2

Official

lung diseases due to external agents (J60-J70)

Related Child Codes

Official

J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection

J44.1Chronic obstructive pulmonary disease with (acute) exacerbation

J44.89Other specified chronic obstructive pulmonary disease

Includes

Official

ICD-10-CM does not list Includes notes for J44.9 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for J44.9 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J44.9 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J44.9 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J44.9 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation clearly stating COPD or chronic obstructive pulmonary disease

Current symptom status such as dyspnea, cough, sputum production, or exercise tolerance

Current medications such as bronchodilators, inhaled corticosteroids, or oxygen therapy

MEAT Support

HCC Buddy guidance

Provider documentation clearly stating COPD or chronic obstructive pulmonary disease

Current symptom status such as dyspnea, cough, sputum production, or exercise tolerance

Current medications such as bronchodilators, inhaled corticosteroids, or oxygen therapy

Audit Caution

HCC Buddy guidance

Do not use J44.9 when documentation supports acute exacerbation, acute lower respiratory infection, or a more specific COPD type.

Common Mistakes

HCC Buddy guidance

J44.1, COPD with acute exacerbation, when acute worsening is documented

J44.0, COPD with acute lower respiratory infection, when a concurrent acute infection is documented

Full codebook view, related codes, and documentation support are available in the encoder.

Full J44.9 card

More complete documentation. Higher RAF impact. Stronger audit defense.

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Live code card preview

J44.9

Chronic obstructive pulmonary disease, unspecified

Billable

CMS-HCC V28

HCC 280

RAF 0.334

CMS-HCC V24

HCC 111

RAF 0.334

Code book path and related codes stay visible.

MEAT and documentation checks are included with Pro.

Ask Buddy follow-ups and saved notes continue after signup.

Pro gives you unlimited searches, notes, evidence checks, bookmarks, and extension sync. The preview stays available either way.

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HCC Buddy Pro

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Code limits, source checks, notes, and Buddy guidance stay in one coder encoder.

Encoder

Search ICD-10-CM and see HCC mapping, billable status, code path, and source period in one code card.

J44.9 code pathOpen Encoder

RAF and Model Values

Compare V24 and V28 values beside the code so risk adjustment impact stays visible during review.

V24 RAF 0.334View J44.9

Evidence Checker

Review deidentified wording for MEAT support, documentation gaps, and strength of evidence.

MEAT supportOpen Evidence

Smart Notes

Save reusable coding notes, payer reminders, and documentation templates in the encoder.

TemplatesOpen Notes

Chrome Extension

Keep HCC lookup close while working across coding tools, charts, and browser workflows.

Floating searchSee Extension

Ask Buddy

Ask coding questions against the encoder context instead of starting from a blank prompt.

Code-aware helpStart Trial

72,000+

ICD-10-CM Codes

V24 + V28

Model Values

MEAT

Documentation Checks

9M+

NPI Records Updated Daily

Source Context

CMS Model Periods

Buddy guided workflow

Scroll through the actual HCC Buddy workflow.

Each chapter has real text and links for search engines, plus product motion for coders. Buddy guides the tool instead of decorating a generic landing page.

Encoder

E11.65 diabetes with hyperglycemiaSearch

E11.65

Type 2 diabetes mellitus with hyperglycemia

Billable

CMS-HCC V28

HCC 38

CMS-HCC V24

HCC 18

RAF

0.450

Code path visible: E11 > E11.6 > E11.65

Search ICD-10-CM and see HCC impact immediately.

The loop opens the encoder, searches E11.65, and reveals billable status, V24, V28, RAF, and code path in the same encoder.

E11.65 searchHCC valuesCode path

Open Encoder

Ask Buddy

Does E11.65 map for V28, and what should I check?

Buddy

Maps to CMS-HCC V28 HCC 38.

Check active diabetes status and treatment.

Look for MEAT in assessment and plan.

Ask the coding question from the encoder.

The loop starts with a code-aware question, then Buddy answers with HCC context, documentation focus, and the next review step.

Code-awareMEAT promptsNext step

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NPI Lookup

Cardiology provider NPIFind

Provider record

Cardiology Provider, MD

NPI

Verified

Taxonomy

Cardiology

Status

Active

Provider context stays connected to code review.

Verify provider context beside the coding work.

The loop searches an NPI, opens the provider card, and confirms credential, taxonomy, and location context without a separate hunt.

Provider recordCredential checkOne tab

Open NPI

Smart Notes

Templates

Diabetes follow-up

COPD status

CHF monitoring

Smart Note

Reminder: confirm current treatment.

A1c, meds, monitoring, follow-up.

Saved as reusable template

Turn coding thoughts into reusable notes.

The loop opens a Smart Note, adds a documentation reminder, and saves it as a reusable coding template.

TemplatesNotesReusable reminders

Open Notes

Medication Lookup

metforminLookup

Metformin

Antihyperglycemic, biguanide

Common diabetes medicationReview renal contextPair with diagnosis supportKeep medication clue close

Check medication context without leaving HCC Buddy.

The loop searches a medication, opens the drug card, and keeps class, common use, and coding context close to the chart review.

Drug searchClassCoding context

Open Drugs

Evidence Support

Deidentified note

Assessment reviewed. A1c ordered. Medication plan discussed.

Monitor

Present

Assess

Present

Gap

Treat

Support strength: documentation support, not final coding.

Separate mapped diagnoses from supported diagnoses.

The loop runs a deidentified evidence check and surfaces MEAT support, gaps, and strength of support before audit risk grows.

MEATSOEGaps

Open Evidence

Chrome Extension

Chart workspace

HCC Buddy

Search J44.9

HCC 280 found

Bring HCC Buddy into the chart workflow.

The extension keeps lookup close while coders work across browser based chart and coding tools. Buddy moves from the site into the workday.

Side panelFast lookupExtension sync

See Extension

Code Page Checks

/icd10/J44.9

Title tag

Canonical

FAQ schema

Sitemap 200

Public code card keeps HCC context visible.

Keep public code pages clear and useful.

The loop checks a public code page, validates structured data, and keeps the lookup path easy to follow.

Code pageSchemaSitemap

View Code Page

Crawlable coding paths

Product pages, code pages, and guides stay open to search engines.

The animated page supports discovery, but the organic traffic engine remains real HTML routes, internal links, sitemaps, and useful public code references.

ICD-10 to HCC search HCC coder tool Risk adjustment coding cheat sheet 2026 HCC list All coding tools MEAT and SOE checker RAF calculator NPI lookup Chrome extension HCC V28 guide HCC Buddy vs ICD10Data

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More complete documentation. Higher RAF impact. Stronger audit defense.

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HCC Buddy keeps the HCC values, MEAT prompts, and source context together so review work is faster to explain and easier to defend.

HCC coder workflow

Source context, notes, and code card review

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