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ICD-10-CM and HCC encoder. Your source, in view.

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J44.9 chronic obstructive pulmonary disease

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E11.65 Search

E11.65 Billable

V28 · PY2026

HCC 38

V24 · PY2025

HCC 18

CNA ref

0.166

ehr-chart · coder view

J44.9

J44.9Billable

V28HCC 280

CNA ref0.319

Code card preview

FY2026 · APR UPDATE

J44.9 Billable

Chronic obstructive pulmonary disease, unspecified
Illustrative card. CNA coefficient references are not member RAF scores.

V28 · PY2026

HCC 280

CNA ref 0.319

V24 · PY2025

HCC 111

Historical reference

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Encoder preview · PY2026 V28 CNA references

E11.65 Billable

Type 2 diabetes mellitus with hyperglycemia

V28 · PY2026

HCC 38

V24 · PY2025

HCC 18

CNA ref

0.166

CODE PATH E11›E11.6›E11.65

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Ask Buddy preview · PY2026 V28

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

Buddy

Maps to CMS-HCC V28 HCC 38.

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Code Book preview · FY2026 April

J44 · Other chronic obstructive pulmonary disease

Chapter Diseases of the respiratory system (J00–J99)

J44 Other chronic obstructive pulmonary disease

J44.0 with (acute) lower respiratory infection

J44.1 with (acute) exacerbation

J44.9 COPD, unspecified Billable HCC 280

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Evidence Checker preview

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Assessment referenced. A1c ordered. Medication plan discussed and continued.

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Monitor

Pending

Assess

Pending

Treat

Pending

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Does J44.9 still map under V28, and what should I confirm?

PY2026 V28: HCC 280. CNA coefficient reference 0.319, not a member RAF score.

Confirm the documented diagnosis and ICD-10-CM instructions.

Review the full documentation and applicable coding guidelines.

Source editions

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Check the published edition and effective period. New sources become available after their files and mappings pass verification.

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HCC mappings and code-level coefficient references are tied to registered CMS-HCC V28 files. The RAF Calculator requires complete member context and shows no score unless every source and calculation check passes.

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Check the selected ICD-10-CM edition and model. Historical code lookup does not imply support for historical RAF scoring.

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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).

V24 is the 2020 CMS-HCC model with 86 payment HCCs; V28 is the 2024 model with 115 payment HCCs. For CY2026 non-PACE Medicare Advantage, CMS completed the V28 phase-in and uses 100% V28. PACE has a separate model blend. HCC Buddy shows current PY2026 V28 mapping and historical PY2025 V24 references separately. Sources: CMS December 2024 Report to Congress, Table 2-2 (https://www.cms.gov/files/document/report-congress-risk-adjustment-medicare-advantage-december-2024.pdf#page=29); CMS 2026 Rate Announcement (https://www.cms.gov/newsroom/fact-sheets/2026-medicare-advantage-part-d-rate-announcement).

A member RAF score combines demographic factors with applicable HCC coefficients after model hierarchy and cleanup rules, plus qualifying interaction terms. HCC Buddy's RAF Calculator supports seven continuing-enrollee segments in CMS-HCC V28 for Payment Year 2026 and requires complete member context. It shows no score unless the required source and calculation checks pass. Code-level coefficients are references, not member totals, and historical PY2025 V24 stays reference-only. PACE, new-enrollee, HHS and ESRD scoring are not supported. Source: CMS Risk Adjustment model software (https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment).

Evidence Checker flags documentation gaps and conflicting wording for coder review. MEAT (Monitor, Evaluate, Assess, Treat) is a review mnemonic, not a substitute for the applicable ICD-10-CM guidelines. A flagged or unflagged result does not establish a diagnosis, reportability or audit acceptance.

For the FY2026 April edition, the published HCC Buddy reference includes 74,719 billable ICD-10-CM codes. Of those, 8,016 have a PY2026 V28 mapping, including six codes with a mapping condition. These are code counts, not HCC category counts or member RAF scores. Check the selected edition and source notes on the ICD-10 to HCC mapping page (https://hccbuddy.com/icd10-to-hcc).

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No. HCC Buddy is built for deidentified coding questions, ICD-10-CM codes, and clinical concepts. Do not paste member identifiers, dates of birth, full chart notes, or other patient identifiers into Ask Buddy.

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Open a source in the Code Book, keep your review in Notes, or share a reference with your team. Coding guides and CMS Watch updates are here too.

Core tools

ICD-10 to HCC search Encoder Code Book Notes Team reference review ICD-10-CM code hub HCC category hub HCC coding software Evidence Checker NPI Lookup Drug Reference Chrome Extension iPhone app and support 2026 HCC code list Printable Cheat Sheet All coding resources

Coding guides

All CMS-HCC categories FY2027 ICD-10-CM changes CMS-HCC V28 Guide ICD-10-CM code lookup ICD-10 to HCC Mapping MEAT Criteria RAF Calculator HCC V28 changes guide RAF score calculation HCC hierarchy trumping rules RADV audit 2026 Coding cheat sheet

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CMS Watch

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CMS Watch Oct 13, 2026 January 2027 HH CB update (CR 14639): A4453 and A4459 leave the non-routine supply list CMS Transmittal R13988CP / CR 14639, issued October 8, 2026, is the January 2027 annual update to HCPCS lists used for Home Health consolidated billing. Effective January 1, 2027, A4453 and A4459 come off the non-routine supply list. A4453 had only been added on October 1, 2026. CMS Watch Oct 12, 2026 October 2026 ASC update (CR 14634): 10 Category III codes, drug PI moves, and two reprocessing windows CMS Transmittal R13983CP, issued October 8, 2026 and effective October 1, sets ASC payment indicators for ten new Category III CPT codes, twelve new pass-through drug codes, eight new skin substitute codes, and 21 drug payment status changes. MACs must also reprocess ASC claims with A9521 back to May 14, 2026 and J9161 back to July 1, 2026. CMS Watch Oct 9, 2026 CR 14582: CMS will reprocess 2023-2024 POS 32 claims that overlap Part A SNF stays CMS Transmittal R13995CP, issued October 8, 2026, tells the Common Working File to run a one-time look-back that flags Part B claim lines billed with POS 32 from May 11, 2023 through December 31, 2024 that overlap a covered Part A SNF or swing-bed stay. MACs will reprocess those lines and recoup any resulting overpayments, with implementation set for April 2027.

ICD-10-CM and HCC encoder. Your source, in view.

HCC Buddy, now on iPhone.

Risk-adjustment coding shouldn't mean ten browser tabs.

Search ICD-10-CM and check the HCC mapping.

Ask the coding question without leaving the encoder.

Browse the ICD-10-CM tabular list the way coders read it.

Separate mapped diagnoses from supported diagnoses.

Keep your coding question beside the source.

Official references, with the source edition in view.

Priced for the coder, not the demo.

Questions? We have answers.

Ready for faster HCC review?

HCC coding paths coders use every day

Latest risk adjustment updates

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