Lung Transplant Status/Complications
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 276 carries a community non-dual aged RAF of 2.531, and 17 payable ICD-10-CM diagnosis codes map to it.
Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026
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.
Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.
V28 hierarchy
Supersedes: HCC 277, HCC 278, HCC 279, HCC 280 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 276 (17)
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.
- J4A.0Restrictive allograft syndrome
- J4A.8Other chronic lung allograft dysfunction
- J4A.9Chronic lung allograft dysfunction, unspecified
- T86.30Unspecified complication of heart-lung transplant
- T86.31Heart-lung transplant rejection
- T86.32Heart-lung transplant failure
- T86.33Heart-lung transplant infection
- T86.39Other complications of heart-lung transplant
- T86.810Lung transplant rejection
- T86.811Lung transplant failure
- T86.812Lung transplant infection
- T86.818Other complications of lung transplant
- T86.819Unspecified complication of lung transplant
- Z48.24Encounter for aftercare following lung transplant
- Z48.280Encounter for aftercare following heart-lung transplant
- Z94.2Lung transplant status
- Z94.3Heart and lungs transplant status
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 276?
HCC 276 is "Lung Transplant Status/Complications", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 17 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 276?
The community non-dual aged relative factor for CMS-HCC V28 category 276 is 2.531. 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 276?
17 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 276 (Lung Transplant Status/Complications) for payment year 2026.
Related condition guides
In-depth HCC coding guides for conditions that map to category 276, with documentation tips, common mistakes, and the V24-to-V28 changes.
Related references
Sources
CMS published ICD-10-CM mapping file plus 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.