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V28 HCC 254

Monoplegia, Other Paralytic Syndromes

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 254 has a source-labeled community non-dual aged reference coefficient of 0.321, and 119 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 180, HCC 181, HCC 191, HCC 192, HCC 253 when a more severe category in the same disease group is also present.

By the HCC Buddy Coding Team · Reviewed: May 30, 2026
V28 HCC 254Community non-dual aged reference coefficient 0.321
See ICD-10-CM codes for HCC 254Open the RAF Calculator

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.

Community NA: 0.321Community PBA: 0.29Community FBA: 0.292Community ND: 0.172Community PBD: 0.335Community FBD: 0.365Institutional: 0

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 180, HCC 181, HCC 191, HCC 192, HCC 253 (a more severe category in the same disease group supersedes this one).

ICD-10-CM codes that map to HCC 254 (119)

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.

Coder workflow notes

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Frequently asked questions

What is CMS-HCC V28 category 254?

HCC 254 is "Monoplegia, Other Paralytic Syndromes", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 119 ICD-10-CM codes appear in its official mapping.

What reference coefficient is published for HCC 254?

The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 254 is 0.321. 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 254?

119 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 254 (Monoplegia, Other Paralytic Syndromes) for payment year 2026.

Which categories trump HCC 254 in the V28 hierarchy?

HCC 254 is superseded by HCC 180 (Quadriplegia), HCC 181 (Paraplegia), HCC 191 (Quadriplegic Cerebral Palsy), HCC 192 (Cerebral Palsy, Except Quadriplegic), HCC 253 (Hemiplegia/Hemiparesis). When a more severe category in the same disease group is documented, it is counted instead of HCC 254.

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.