V28 HCC 202
Coma, Brain Compression/Anoxic Damage
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 202 has a source-labeled community non-dual aged reference coefficient of 0.543, and 61 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 63, HCC 397, HCC 398 when a more severe category in the same disease group is also present.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 63, HCC 397, HCC 398 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 202 (61)
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.
- E03.5Myxedema coma
- G93.1Anoxic brain damage, not elsewhere classified
- G93.5Compression of brain
- G93.6Cerebral edema
- P91.0Neonatal cerebral ischemia
- P91.1Acquired periventricular cysts of newborn
- P91.2Neonatal cerebral leukomalacia
- P91.3Neonatal cerebral irritability
- P91.4Neonatal cerebral depression
- P91.5Neonatal coma
- P91.60Hypoxic ischemic encephalopathy [HIE], unspecified
- P91.61Mild hypoxic ischemic encephalopathy [HIE]
- P91.62Moderate hypoxic ischemic encephalopathy [HIE]
- P91.63Severe hypoxic ischemic encephalopathy [HIE]
- P91.811Neonatal encephalopathy in diseases classified elsewhere
- P91.819Neonatal encephalopathy, unspecified
- P91.88Other specified disturbances of cerebral status of newborn
- P91.9Disturbance of cerebral status of newborn, unspecified
- R40.20Unspecified coma
- R40.2110Coma scale, eyes open, never, unspecified time
- R40.2111Coma scale, eyes open, never, in the field [EMT or ambulance]
- R40.2112Coma scale, eyes open, never, at arrival to emergency department
- R40.2113Coma scale, eyes open, never, at hospital admission
- R40.2114Coma scale, eyes open, never, 24 hours or more after hospital admission
- R40.2120Coma scale, eyes open, to pain, unspecified time
- R40.2121Coma scale, eyes open, to pain, in the field [EMT or ambulance]
- R40.2122Coma scale, eyes open, to pain, at arrival to emergency department
- R40.2123Coma scale, eyes open, to pain, at hospital admission
- R40.2124Coma scale, eyes open, to pain, 24 hours or more after hospital admission
- R40.2210Coma scale, best verbal response, none, unspecified time
- R40.2211Coma scale, best verbal response, none, in the field [EMT or ambulance]
- R40.2212Coma scale, best verbal response, none, at arrival to emergency department
- R40.2213Coma scale, best verbal response, none, at hospital admission
- R40.2214Coma scale, best verbal response, none, 24 hours or more after hospital admission
- R40.2220Coma scale, best verbal response, incomprehensible words, unspecified time
- R40.2221Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance]
- R40.2222Coma scale, best verbal response, incomprehensible words, at arrival to emergency department
- R40.2223Coma scale, best verbal response, incomprehensible words, at hospital admission
- R40.2224Coma scale, best verbal response, incomprehensible words, 24 hours or more after hospital admission
- R40.2310Coma scale, best motor response, none, unspecified time
- R40.2311Coma scale, best motor response, none, in the field [EMT or ambulance]
- R40.2312Coma scale, best motor response, none, at arrival to emergency department
- R40.2313Coma scale, best motor response, none, at hospital admission
- R40.2314Coma scale, best motor response, none, 24 hours or more after hospital admission
- R40.2320Coma scale, best motor response, extension, unspecified time
- R40.2321Coma scale, best motor response, extension, in the field [EMT or ambulance]
- R40.2322Coma scale, best motor response, extension, at arrival to emergency department
- R40.2323Coma scale, best motor response, extension, at hospital admission
- R40.2324Coma scale, best motor response, extension, 24 hours or more after hospital admission
- R40.2430Glasgow coma scale score 3-8, unspecified time
- R40.2431Glasgow coma scale score 3-8, in the field [EMT or ambulance]
- R40.2432Glasgow coma scale score 3-8, at arrival to emergency department
- R40.2433Glasgow coma scale score 3-8, at hospital admission
- R40.2434Glasgow coma scale score 3-8, 24 hours or more after hospital admission
- R40.2440Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time
- R40.2441Other coma, without documented Glasgow coma scale score, or with partial score reported, in the field [EMT or ambulance]
- R40.2442Other coma, without documented Glasgow coma scale score, or with partial score reported, at arrival to emergency department
- R40.2443Other coma, without documented Glasgow coma scale score, or with partial score reported, at hospital admission
- R40.2444Other coma, without documented Glasgow coma scale score, or with partial score reported, 24 hours or more after hospital admission
- R40.2ANontraumatic coma due to underlying condition
- R40.3Persistent vegetative state
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 202?
HCC 202 is "Coma, Brain Compression/Anoxic Damage", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 61 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 202?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 202 is 0.543. 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 202?
61 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 202 (Coma, Brain Compression/Anoxic Damage) for payment year 2026.
Which categories trump HCC 202 in the V28 hierarchy?
HCC 202 is superseded by HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 397 (Major Head Injury with Loss of Consciousness > 1 Hour), HCC 398 (Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified). When a more severe category in the same disease group is documented, it is counted instead of HCC 202.
Related condition guides
In-depth HCC coding guides for conditions that map to category 202, 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.