V28 HCC 65
Chronic Hepatitis
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 65 has a source-labeled community non-dual aged reference coefficient of 0.185, and 17 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 62, HCC 63, HCC 64 when a more severe category in the same disease group is also present.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 62, HCC 63, HCC 64 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 65 (17)
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.
- B18.0Chronic viral hepatitis B with delta-agent
- B18.1Chronic viral hepatitis B without delta-agent
- B18.2Chronic viral hepatitis C
- B18.8Other chronic viral hepatitis
- B18.9Chronic viral hepatitis, unspecified
- K70.10Alcoholic hepatitis without ascites
- K70.11Alcoholic hepatitis with ascites
- K71.3Toxic liver disease with chronic persistent hepatitis
- K71.4Toxic liver disease with chronic lobular hepatitis
- K71.50Toxic liver disease with chronic active hepatitis without ascites
- K71.51Toxic liver disease with chronic active hepatitis with ascites
- K73.0Chronic persistent hepatitis, not elsewhere classified
- K73.1Chronic lobular hepatitis, not elsewhere classified
- K73.2Chronic active hepatitis, not elsewhere classified
- K73.8Other chronic hepatitis, not elsewhere classified
- K73.9Chronic hepatitis, unspecified
- K75.4Autoimmune hepatitis
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 65?
HCC 65 is "Chronic Hepatitis", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 17 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 65?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 65 is 0.185. 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 65?
17 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 65 (Chronic Hepatitis) for payment year 2026.
Which categories trump HCC 65 in the V28 hierarchy?
HCC 65 is superseded by HCC 62 (Liver Transplant Status/Complications), HCC 63 (Chronic Liver Failure/End-Stage Liver Disorders), HCC 64 (Cirrhosis of Liver). When a more severe category in the same disease group is documented, it is counted instead of HCC 65.
Related condition guides
In-depth HCC coding guides for conditions that map to category 65, 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.