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V28 HCC 298

Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 298 has a source-labeled community non-dual aged reference coefficient of 0.336, and 180 ICD-10-CM diagnosis codes appear in its official mapping.

By the HCC Buddy Coding Team · Reviewed: May 30, 2026
V28 HCC 298Community non-dual aged reference coefficient 0.336
See ICD-10-CM codes for HCC 298Open 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: 0.336Community PBA: 0.327Community FBA: 0.323Community ND: 0.364Community PBD: 0.301Community FBD: 0.319Institutional: 0.545

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 298 (180)

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 298?

HCC 298 is "Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 180 ICD-10-CM codes appear in its official mapping.

What reference coefficient is published for HCC 298?

The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 298 is 0.336. 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 298?

180 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage) for payment year 2026.

Related condition guides

In-depth HCC coding guides for conditions that map to category 298, 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.