V28 HCC 115
Specified Immunodeficiencies and White Blood Cell Disorders
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 115 has a source-labeled community non-dual aged reference coefficient of 0.565, and 18 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 114 when a more severe category in the same disease group is also present.
RAF factors
The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
V28 hierarchy
Trumped by: HCC 114 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 115 (18)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.
- D70.0Congenital agranulocytosis
- D70.4Cyclic neutropenia
- D71.1Leukocyte adhesion deficiency
- D71.8Other functional disorders of polymorphonuclear neutrophils
- D71.9Functional disorders of polymorphonuclear neutrophils, unspecified
- D72.0Genetic anomalies of leukocytes
- D76.1Hemophagocytic lymphohistiocytosis
- D76.3Other histiocytosis syndromes
- D80.0Hereditary hypogammaglobulinemia
- D80.2Selective deficiency of immunoglobulin A [IgA]
- D80.3Selective deficiency of immunoglobulin G [IgG] subclasses
- D80.4Selective deficiency of immunoglobulin M [IgM]
- D80.5Immunodeficiency with increased immunoglobulin M [IgM]
- D81.4Nezelof's syndrome
- D82.0Wiskott-Aldrich syndrome
- D82.1Di George's syndrome
- D84.1Defects in the complement system
- D89.84IgG4-related disease
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 115?
HCC 115 is "Specified Immunodeficiencies and White Blood Cell Disorders", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 18 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 115?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 115 is 0.565. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 115?
18 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 115 (Specified Immunodeficiencies and White Blood Cell Disorders) for payment year 2026.
Which categories trump HCC 115 in the V28 hierarchy?
HCC 115 is superseded by HCC 114 (Common Variable and Combined Immunodeficiencies). When a more severe category in the same disease group is documented, it is counted instead of HCC 115.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.