V28 HCC 127
Dementia, Mild or Unspecified
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 127 has a source-labeled community non-dual aged reference coefficient of 0.341, and 65 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 125, HCC 126 when a more severe category in the same disease group is also present.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 125, HCC 126 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 127 (65)
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.
- A81.00Creutzfeldt-Jakob disease, unspecified
- A81.01Variant Creutzfeldt-Jakob disease
- A81.09Other Creutzfeldt-Jakob disease
- A81.1Subacute sclerosing panencephalitis
- A81.2Progressive multifocal leukoencephalopathy
- A81.81Kuru
- A81.82Gerstmann-Straussler-Scheinker syndrome
- A81.83Fatal familial insomnia
- A81.89Other atypical virus infections of central nervous system
- A81.9Atypical virus infection of central nervous system, unspecified
- F01.50Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F01.511Vascular dementia, unspecified severity, with agitation
- F01.518Vascular dementia, unspecified severity, with other behavioral disturbance
- F01.52Vascular dementia, unspecified severity, with psychotic disturbance
- F01.53Vascular dementia, unspecified severity, with mood disturbance
- F01.54Vascular dementia, unspecified severity, with anxiety
- F01.A0Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F01.A11Vascular dementia, mild, with agitation
- F01.A18Vascular dementia, mild, with other behavioral disturbance
- F01.A2Vascular dementia, mild, with psychotic disturbance
- F01.A3Vascular dementia, mild, with mood disturbance
- F01.A4Vascular dementia, mild, with anxiety
- F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F02.811Dementia in other diseases classified elsewhere, unspecified severity, with agitation
- F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
- F02.82Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance
- F02.83Dementia in other diseases classified elsewhere, unspecified severity, with mood disturbance
- F02.84Dementia in other diseases classified elsewhere, unspecified severity, with anxiety
- F02.A0Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F02.A11Dementia in other diseases classified elsewhere, mild, with agitation
- F02.A18Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance
- F02.A2Dementia in other diseases classified elsewhere, mild, with psychotic disturbance
- F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance
- F02.A4Dementia in other diseases classified elsewhere, mild, with anxiety
- F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.911Unspecified dementia, unspecified severity, with agitation
- F03.918Unspecified dementia, unspecified severity, with other behavioral disturbance
- F03.92Unspecified dementia, unspecified severity, with psychotic disturbance
- F03.93Unspecified dementia, unspecified severity, with mood disturbance
- F03.94Unspecified dementia, unspecified severity, with anxiety
- F03.A0Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.A11Unspecified dementia, mild, with agitation
- F03.A18Unspecified dementia, mild, with other behavioral disturbance
- F03.A2Unspecified dementia, mild, with psychotic disturbance
- F03.A3Unspecified dementia, mild, with mood disturbance
- F03.A4Unspecified dementia, mild, with anxiety
- G30.0Alzheimer's disease with early onset
- G30.1Alzheimer's disease with late onset
- G30.8Other Alzheimer's disease
- G30.9Alzheimer's disease, unspecified
- G31.01Pick's disease
- G31.09Other frontotemporal neurocognitive disorder
- G31.81Alpers disease
- G31.82Leigh's disease
- G31.83Neurocognitive disorder with Lewy bodies
- G31.86Alexander disease
- G91.0Communicating hydrocephalus
- G91.1Obstructive hydrocephalus
- G91.2(Idiopathic) normal pressure hydrocephalus
- G91.3Post-traumatic hydrocephalus, unspecified
- G91.4Hydrocephalus in diseases classified elsewhere
- G91.8Other hydrocephalus
- G91.9Hydrocephalus, unspecified
- G93.7Reye's syndrome
- I67.3Progressive vascular leukoencephalopathy
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 127?
HCC 127 is "Dementia, Mild or Unspecified", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 65 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 127?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 127 is 0.341. 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 127?
65 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 127 (Dementia, Mild or Unspecified) for payment year 2026.
Which categories trump HCC 127 in the V28 hierarchy?
HCC 127 is superseded by HCC 125 (Dementia, Severe), HCC 126 (Dementia, Moderate). When a more severe category in the same disease group is documented, it is counted instead of HCC 127.
Related condition guides
In-depth HCC coding guides for conditions that map to category 127, with documentation tips, common mistakes, and the V24-to-V28 changes.
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.