Acute on Chronic Heart Failure
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 224 carries a community non-dual aged RAF of 0.36, and 3 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 221, HCC 222, HCC 223 when a more severe category in the same disease group is also present.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.
V28 hierarchy
Trumped by: HCC 221, HCC 222, HCC 223 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 225, HCC 226, HCC 227 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 224 (3)
Payable diagnosis codes that map to this category under CMS-HCC V28 PY2026. Open any code for its full description, HCC mapping, and coding guidance.
Frequently asked questions
What is CMS-HCC V28 category 224?
HCC 224 is "Acute on Chronic Heart Failure", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 3 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 224?
The community non-dual aged relative factor for CMS-HCC V28 category 224 is 0.36. The exact factor varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 Rate Announcement.
How many ICD-10-CM codes map to HCC 224?
3 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 224 (Acute on Chronic Heart Failure) for payment year 2026.
Which categories trump HCC 224 in the V28 hierarchy?
HCC 224 is superseded by HCC 221 (Heart Transplant Status/Complications), HCC 222 (End Stage Heart Failure), HCC 223 (Heart Assist Device/Artificial Heart). When a more severe category in the same disease group is documented, it is counted instead of HCC 224.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.