V28 HCC 201
Seizure Disorders and Convulsions
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 201 has a source-labeled community non-dual aged reference coefficient of 0.245, and 64 ICD-10-CM diagnosis codes appear in its official mapping.
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.
ICD-10-CM codes that map to HCC 201 (64)
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.
- G40.001Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus
- G40.009Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus
- G40.011Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus
- G40.019Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus
- G40.101Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
- G40.109Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
- G40.111Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
- G40.119Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
- G40.201Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus
- G40.209Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
- G40.211Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
- G40.219Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus
- G40.301Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus
- G40.309Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus
- G40.311Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus
- G40.319Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus
- G40.401Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus
- G40.409Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus
- G40.411Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus
- G40.419Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus
- G40.42Cyclin-Dependent Kinase-Like 5 Deficiency Disorder
- G40.501Epileptic seizures related to external causes, not intractable, with status epilepticus
- G40.509Epileptic seizures related to external causes, not intractable, without status epilepticus
- G40.801Other epilepsy, not intractable, with status epilepticus
- G40.802Other epilepsy, not intractable, without status epilepticus
- G40.803Other epilepsy, intractable, with status epilepticus
- G40.804Other epilepsy, intractable, without status epilepticus
- G40.811Lennox-Gastaut syndrome, not intractable, with status epilepticus
- G40.812Lennox-Gastaut syndrome, not intractable, without status epilepticus
- G40.813Lennox-Gastaut syndrome, intractable, with status epilepticus
- G40.814Lennox-Gastaut syndrome, intractable, without status epilepticus
- G40.821Epileptic spasms, not intractable, with status epilepticus
- G40.822Epileptic spasms, not intractable, without status epilepticus
- G40.823Epileptic spasms, intractable, with status epilepticus
- G40.824Epileptic spasms, intractable, without status epilepticus
- G40.833Dravet syndrome, intractable, with status epilepticus
- G40.834Dravet syndrome, intractable, without status epilepticus
- G40.841KCNQ2-related epilepsy, not intractable, with status epilepticus
- G40.842KCNQ2-related epilepsy, not intractable, without status epilepticus
- G40.843KCNQ2-related epilepsy, intractable, with status epilepticus
- G40.844KCNQ2-related epilepsy, intractable, without status epilepticus
- G40.89Other seizures
- G40.901Epilepsy, unspecified, not intractable, with status epilepticus
- G40.909Epilepsy, unspecified, not intractable, without status epilepticus
- G40.911Epilepsy, unspecified, intractable, with status epilepticus
- G40.919Epilepsy, unspecified, intractable, without status epilepticus
- G40.A01Absence epileptic syndrome, not intractable, with status epilepticus
- G40.A09Absence epileptic syndrome, not intractable, without status epilepticus
- G40.A11Absence epileptic syndrome, intractable, with status epilepticus
- G40.A19Absence epileptic syndrome, intractable, without status epilepticus
- G40.B01Juvenile myoclonic epilepsy, not intractable, with status epilepticus
- G40.B09Juvenile myoclonic epilepsy, not intractable, without status epilepticus
- G40.B11Juvenile myoclonic epilepsy, intractable, with status epilepticus
- G40.B19Juvenile myoclonic epilepsy, intractable, without status epilepticus
- G40.C01Lafora progressive myoclonus epilepsy, not intractable, with status epilepticus
- G40.C09Lafora progressive myoclonus epilepsy, not intractable, without status epilepticus
- G40.C11Lafora progressive myoclonus epilepsy, intractable, with status epilepticus
- G40.C19Lafora progressive myoclonus epilepsy, intractable, without status epilepticus
- G93.45Developmental and epileptic encephalopathy
- P90Convulsions of newborn
- R56.00Simple febrile convulsions
- R56.01Complex febrile convulsions
- R56.1Post traumatic seizures
- R56.9Unspecified convulsions
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 201?
HCC 201 is "Seizure Disorders and Convulsions", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 64 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 201?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 201 is 0.245. 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 201?
64 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 201 (Seizure Disorders and Convulsions) for payment year 2026.
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.