User Guide
Getting started:
To get started, visit our customer Portal and create an account. On the Menu panel select MSCORE™ and download the version of the application best suited for your Operating System (OS). Your license key, required to activate the application, is also provided on this page. An email will also be sent to the registered address with your license key.
*Under a paid plan, the license key can be shared with multiple machines on the same plan; however, all scores run using this key will be charged.
Quick Start:
Once the application is downloaded, it can be accessed through either the Graphical User Interface (GUI) or Command Line Interface (CLI). The license key may be submitted via the GUI or CLI. Open the application, enter your license key when prompted, and click Submit/Enter.
If you are not activating a paid account, you will receive a message stating a trial license was activated and is valid until a specified date. A paid account can be activated by visiting the Customer Portal at the link provided. A link to contact Customer Support is also available.
Navigate to the Graphical User Interface Tutorial or Command Line Interface Tutorial sections for details on application features and directions on use.
Graphical User Interface Tutorial:
To activate the application, enter your license key when prompted, and click Submit.
A window will open where input files can be uploaded, output directory and file types selected, and Model preferences can be elected.
Diagnosis File
Upload file by providing the full file path name. A Diagnosis file is required for Model execution. Accepted input format is CSV. This field can be entered manually; however, we recommend using the browser button for streamlined navigation and to eliminate user input errors.
Required Diagnosis input file format:
| Field Name | Description | Values | Format |
|---|---|---|---|
| MBI | Person identification variable | Unique to each individual | Character/Numeric |
| DIAG | Diagnosis | ICD-10 codes of up to 7 characters with no periods. Note: By default, the model performs the Medicare Code Editor edits on the submitted diagnosis codes. | Character |
Person File
Upload file by providing the full file path name. A Person file is required for Model execution. Accepted input format is CSV. This field can be entered manually; however, we recommend using the browser button for streamlined navigation and to eliminate user input errors.
Required Person input file format:
| Field Name | Description | Values | Format |
|---|---|---|---|
| MBI | Person identification variable | Unique to each individual | Character/Numeric |
| SEX | Beneficiary Sex | 1= Male 2= Female |
Character |
| DOB | Beneficiary Date of Birth | All date formats except numeric dates in day/month/year format. | Date |
| LTIMCAID | Medicare Beneficiary Has Medicaid | 1= Number of Medicaid months in payment year > 0 0=Number of Medicaid months in payment year =0 |
Numeric |
| NEMCAID | New Medicare Beneficiary with Medicaid | 1= New Medicare enrollee with number of months in Medicaid in payment year >0 2= Otherwise |
Numeric |
| OREC | Original Reason for Entitlement | 0= Old Age(OASI) 1= Disability (DIB) 2= ESRD 3= Both DIB and ESRD |
Charcter |
Output Directory
Enter the location where you want scored results saved. This field can be entered manually; however, we recommend using the browser button for streamlined navigation and to eliminate user input errors.
Output File Name
Name your score file in the Output File Name field. Do not add the file extension.
Output File Type
Currently only the CSV format is available
Model Type
Select a Model Type from the dropdown. Currently only the CMS-HCC Model is supported in the application.
Model Version
Select a Model Version (V24 or V22) from the dropdown.
Model Year
Select a Model Year (2021 or 2022) from the dropdown.
Select Columns to Include in Output
Select columns (Scores Only, Scores & Demography, Scores, Demography & HCC, Scores, Demography, HCC & CC, Scores, HCC & Interactions, or All Fields) to include on your output scored file.
Once all selections are made, click on Run Scores, and navigate to your designated Output Directory to view results. A window will open notifying you that the scoring is complete and includes the file name and location. Output data will be provided in one of the following formats depending on selected Model Version listed at the end of this document.
Command Line Interface Tutorial:
A powerful feature of this application is the Command Line Interface (CLI) option, that eliminates the need for a Graphical User Interface (GUI).
Depending on your Operating System (OS), open terminal or PowerShell, and navigate to location of the application. To skip this step, provide the full file path location when you input arguments.
A list of accepted input arguments are available using --help command.
- Mac/Linux: ./Mscore --help
- Windows: .\Mscore --help
The below input arguments are required to run the application:
- --personFile
- --diagFile
- --modelYear
- --modelVersion
- --modelType
- --outputColumns
- --outputDir
- --outFileName
- --fileExt
Linux:
Windows:
**Note when running the application via the CLI command on Windows, you will need to append the last argument with ‘ | more ‘ to receive a printout statement upon completion of the score run. If you do not add it, your scores will still be processed without any return text.
Output File Format (field names sorted alphabetically): Output data will be provided in one of the following formats depending on selected Model Version.
| Field Name | Description | Values | Format | Output | Model | |
|---|---|---|---|---|---|---|
| AGE | Beneficiary Age as of Feb 1 of User-Specified Payment Year | Two or three digit age | Numeric | Demographic | V22, V24 |
|
| AGE_RANGES | Beneficiary Age Category | 0_34= 0 to 34 Years Old 35_44= 35 to 44 Years Old 45_54= 45 to 54 Years Old 55_59= 55 to 59 Years Old 60_64= 60 to 64 Years Old 65_69= 65 to 69 Years Old 70_74= 70 to 74 Years Old 75_79= 75 to 79 Years Old 80_84= 80 to 84 Years Old 85_89= 85 to 89 Years Old 90_94= 90 to 94 Years Old 95 to GT= 95 Years Old and Up |
Character | Demographic | V22, V24 |
|
| AGE_SEX | Beneficiary Sex and Age Range | F0_34 = 0 to 34 Year Old Female F35_44= 35 to 44 Year Old Female F45_54= 45 to 54 Year Old Female F55_59= 55 to 59 Year Old Female F60_64= 60 to 64 Year Old Female F65_69= 65 to 69 Year Old Female F70_74= 70 to 74 Year Old Female F75_79= 75 to 79 Year Old Female F80_84= 80 to 84 Year Old Female F85_89= 85 to 89 Year Old Female F90_94= 90 to 94 Year Old Female F95_GT= 95+ Year Old Female M0_34 = 0 to 34 Year Old Male M35_44= 35 to 44 Year Old Male M45_54= 45 to 54 Year Old Male M55_59= 55 to 59 Year Old Male M60_64= 60 to 64 Year Old Male M65_69= 65 to 69 Year Old Male M70_74= 70 to 74 Year Old Male M75_79= 75 to 79 Year Old Male M80_84= 80 to 84 Year Old Male M85_89= 85 to 89 Year Old Male M90_94= 90 to 94 Year Old Male M95_GT= 95+ Year Old Male |
Character | Demographic | V22, V24 |
|
| ART_OPENINGS_PRES_ULC | Beneficiary has both the Artificial Openings HCC [188] and at least one Pressure Ulcer HCC [V22=157/158, V24=157/158/159] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| ASP_SPEC_BACT_PNEUM_PRES_ULC | Beneficiary has both the Aspiration and Specified Bacterial Pneumonias HCC [114] and at least one Pressure Ulcers HCC [V22=157/158, V24=157/158/159] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| CANCER | Beneficiary has at least one Cancer HCC [8/9/1/11/12] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| CARD_RESP_FAIL | Beneficiary has at least one of Cardio-Respiratory Failure and Shock, CHF, or AMI HCC(s) [82/83/84] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| CC | List of Beneficiary's Condition Category codes, separated by "," and enclosed with "[]" | Varies | Character | CC | V22, V24 |
|
| CFA_SCORE | Community Full Benefit Dual Aged Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| CFD_SCORE | Community Full Benefit Dual Disabled Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| CHF | Beneficiary has the CHF HCC [85] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| CHF_GCOPDCF | Beneficiary has both the CHF HCC [85] and at least one of the COPD/CF HCCs [110/111/112] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| CNA_SCORE | Community Non-Dual Aged Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| CND_SCORE | Community Non-Dual Disabled Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| CPA_SCORE | Community Partial Benefit Dual Aged Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| CPD_SCORE | Community Partial Benefit Dual Disabled Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| D | Number of HCCs Assigned to Beneficiary | D1= 1 HCC D2= 2 HCCs D3= 3 HCCs D4= 4 HCCs D5= 5 HCCs D6= 6 HCCs D7= 7 HCCs D8= 8 HCCs D9= 9 HCCS D10P= 10+ HCCs |
Character | HCC | V24 | |
| DIABETES | Beneficiary has at least one Diabetes HCC [17/18/19] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DIABETES_CHF | Beneficiary has at least one Diabetes HCC [17/18/19] and the CHF HCC [85] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DISABL | Disability Indicator: Beneficiary is Less Than 65 Years Old and Original Entitlement Not Due to Old Age | 0= No 1= Yes |
Numeric | Demographic | V22, V24 |
|
| DISABLED_HCC161 | Beneficiary is Disabled and has the Chronic Ulcer of Skin, Except Pressure HCC [161] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DISABLED_HCC39 | Beneficiary is Disabled and has the Bone/Joint/Muscle Infections/Necrosis HCC [39] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DISABLED_HCC6 | Beneficiary is Disabled and has the Opportunistic Infections HCC [6] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DISABLED_HCC77 | Beneficiary is Disabled and has the Multiple Sclerosis HCC [77] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DISABLED_HCC85 | Beneficiary is Disabled and has the CHF HCC [85] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DISABLED_PRESSURE_ULCER | Beneficiary is Disabled and has at least one Pressure Ulcer HCC [v22=157/158, v24=157/158/159] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| DOB | Beneficiary Date of Birth | All date formats except numeric dates in day/month/year format. | Date (month/day/year) | Demographic | V22, V24 |
|
| GCOPDCF | Beneficiary has at least one of COPD and/or CF HCC(s) [110/111/112] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| GCOPDCF_ASP_SPEC_BACT_PNEUM | Beneficiary has at least one of the COPD/CF HCCs [110/111/112] and the Aspiration and Specified Bacterial Pneumonias HCC [114] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| GCOPDCF_CARD_RESP_FAIL | Beneficiary has at least one of the COPD/CF HCCs [110/111/112] and at least one of Cardio-Respiratory Failure and Shock, CHF, or AMI HCC(s) [82/83/84] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| GPSYCH | Beneficiary has at least one Psychiatric HCC [v22=57/58, v24=57/58/59/60] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| GRESPDEPANDARRE_GCOPDCF | Beneficiary has both Cardiorespiratory Failure HCC [84] and at least one of COPD and/or CF HCC(s) [110/111/112] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| GSUBSTANCEUSEDISORDER | Beneficiary has at least one Substance Use Disorder HCC [v22=54/55, v24=54/55/56] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| GSUBSTANCEUSEDISORDER_GPSYCH | Beneficiary has both a Substance Use Disorder HCC [v22=54/55, v24=54/55/56] and at least one Psychiatric HCC [v22=57/58, v24=57/58/59/60] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| HCC | List of Beneficiary's Hierarchical Condition Category codes, separated by "," and enclosed with "[]" | Varies | Character | HCC | V22, V24 |
|
| HCC_COUNT | Number of HCCs Assigned to Beneficiary | Varies | Numeric | HCC | V22, V24 |
|
| HCC47_GCANCER | Beneficiary has both the Immune Disorders HCC [47] and at least one Cancer HCC [8/9/10/11/12] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| HCC85_GCOPDCF | Beneficiary has both the Congestive Heart Failure HCC [85] and has at least one of COPD and/or CF HCC(s) [110/111/112] | 0= No 1= Yes |
Numeric | Interaction | V22 | |
| HCC85_GDIABETESMELLIT | Beneficiary has both the Congestive Heart Failure HCC [85] and has at least one Diabetes HCC [17/18/19] | 0= No 1= Yes |
Numeric | Interaction | V22 | |
| HCC85_HCC96 | Beneficiary has both the CHF HCC [85] and the Specified Heart Arrhythmias HCC [96] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| HCC85_RENAL | Beneficiary has both the Congestive Heart Failure HCC [85] and at least one Renal HCC [v22=134/135/136/137, v24=134/135/136/137/138] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| INS_SCORE | Institutional Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| LTIMCAID | Medicare Beneficiary Has Medicaid | 1= Number of Medicaid months in payment year > 0 0=Number of Medicaid months in payment year =0 |
Numeric | Demographic | V22, V24 |
|
| MBI | Person identification variable | Unique to each individual | Character/Numeric | Demographic | V22, V24 |
|
| N_MCAID_N_ORIGDS | Combined Indicator of Medicaid and Originally Disabled | MCAID_NORIGDIS= Medicaid, Not Originally Disabled MCAID_ORIGDIS= Medicaid, Originally Disabled NMCAID_NORIGDIS= No Medicaid, Not Originally Disabled NMCAID_ORIGDIS= No Medicaid, Originally Disabled |
Character | Demographic | V22, V24 |
|
| NE_AGE_RANGES | Beneficiary Age Category - Breakout of 65-69 years Olds for New Enrollees | 0_34= 0 to 34 Years Old 35_44= 35 to 44 Years Old 45_54= 45 to 54 Years Old 55_59= 55 to 59 Years Old 60_64= 60 to 64 Years Old 65= 65 Years Old 66= 66 Years Old 67= 67 Years Old 68= 68 Years Old 69= 69 Years Old 70_74= 70 to 74 Years Old 75_79= 75 to 79 Years Old 80_84= 80 to 84 Years Old 85_89= 85 to 89 Years Old 90_94= 90 to 94 Years Old 95 to GT= 95 Years Old and Up |
Character | Demographic | V22, V24 |
|
| NE_ORIGDS | New Enrollee- Originally Disabled | 0= Less Than 65 Years Old or Not Originally Disabled 1= At Least 65 Years Old and Originally Disabled |
Numeric | Demographic | V22, V24 |
|
| NE_SCORE | New Enrollee Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
|
| NEMCAID | New Medicare Beneficiary with Medicaid | 1= New Medicare enrollee with number of months in Medicaid in payment year >0 2= Otherwise |
Numeric | Demographic | V22, V24 |
|
| OREC | Original Reason for Entitlement | 0= Old Age(OASI) 1= Disability (DIB) 2= ESRD 3= Both DIB and ESRD |
Character | Demographic | V22, V24 |
|
| ORIG_DS_M_F | Combined Indicator of Originally Disabled and Beneficiary Sex | OriginallyDisabled_Female= Originally Disabled and Female OriginallyDisabled_Male= Originally Disabled and Male NULL= Not Originally Disabled | Character | Demographic | V22, V24 |
|
| ORIGDS | Original Reason for Beneficiary's Medicare Entitlement is Due to Disability | 0= Not Originally Qualified as Disabled 1= Originally Qualified as Disabled |
Character | Demographic | V22, V24 |
|
| PRESSURE_ULCER | Beneficiary has at least one Pressure Ulcer HCC [v22=157/158, v24=157/158/159] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| RENAL | Beneficiary has at least one Renal HCC [v22=134/135/136/137, v24=134/135/136/137/138] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SCHIZOPHRENIA_CHF | Beneficiary has both the Schizophrenia HCC [57] and the CHF HCC [85] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SCHIZOPHRENIA_GCOPDCF | Beneficiary has both the Schizophrenia HCC [57] and at least one of the COPD/CF HCCs [110/111/112] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SCHIZOPHRENIA_SEIZURES | Beneficiary has both the Schizophrenia HCC [57] and the Seizure Disorders and Convulsions HCC [79] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SEPSIS | Beneficiary has the Sepsis HCC [2] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SEPSIS_ARTIF_OPENINGS | Beneficiary has both the Sepsis HCC [2] and the Artificial Openings HCC [188] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SEPSIS_ASP_SPEC_BACT_PNEUM | Beneficiary has both the Sepsis HCC [2] and the Aspiration and Specified Bacterial Pneumonias HCC [114] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SEPSIS_PRESSURE_ULCER | Beneficiary has both the Sepsis HCC [2] and at least one Pressure Ulcer HCC [v22=157/158, v24=157/158/159] | 0= No 1= Yes |
Numeric | Interaction | V22, V24 |
|
| SEX | Beneficiary Sex | 1= Male 2= Female |
Character | Demographic | V22, V24 |
|
| SNPNE_SCORE | New Enrollee SNP Risk Score | Risk adjustment factor with up to 3 decimals | Numeric | Score | V22, V24 |
Model HCCs: Below is a list of HCC for each model version.
CMS-HCC Version 22 (V22)
| HCC | Description |
|---|---|
| HCC1 | HIV/AIDS |
| HCC2 | Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock |
| HCC6 | Opportunistic Infections |
| HCC8 | Metastatic Cancer and Acute Leukemia |
| HCC9 | Lung and Other Severe Cancers |
| HCC10 | Lymphoma and Other Cancers |
| HCC11 | Colorectal, Bladder, and Other Cancers |
| HCC12 | Breast, Prostate, and Other Cancers and Tumors |
| HCC17 | Diabetes with Acute Complications |
| HCC18 | Diabetes with Chronic Complications |
| HCC19 | Diabetes without Complication |
| HCC21 | Protein-Calorie Malnutrition |
| HCC22 | Morbid Obesity |
| HCC23 | Other Significant Endocrine and Metabolic Disorders |
| HCC27 | End-Stage Liver Disease |
| HCC28 | Cirrhosis of Liver |
| HCC29 | Chronic Hepatitis |
| HCC33 | Intestinal Obstruction/Perforation |
| HCC34 | Chronic Pancreatitis |
| HCC35 | Inflammatory Bowel Disease |
| HCC39 | Bone/Joint/Muscle Infections/Necrosis |
| HCC40 | Rheumatoid Arthritis and Inflammatory Connective Tissue Disease |
| HCC46 | Severe Hematological Disorders |
| HCC47 | Disorders of Immunity |
| HCC48 | Coagulation Defects and Other Specified Hematological Disorders |
| HCC54 | Drug/Alcohol Psychosis |
| HCC55 | Drug/Alcohol Dependence |
| HCC57 | Schizophrenia |
| HCC58 | Major Depressive, Bipolar, and Paranoid Disorders |
| HCC70 | Quadriplegia |
| HCC71 | Paraplegia |
| HCC72 | Spinal Cord Disorders/Injuries |
| HCC73 | Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease |
| HCC74 | Cerebral Palsy |
| HCC75 | Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy |
| HCC76 | Muscular Dystrophy |
| HCC77 | Multiple Sclerosis |
| HCC78 | Parkinson's and Huntington's Diseases |
| HCC79 | Seizure Disorders and Convulsions |
| HCC80 | Coma, Brain Compression/Anoxic Damage |
| HCC82 | Respirator Dependence/Tracheostomy Status |
| HCC83 | Respiratory Arrest |
| HCC84 | Cardio-Respiratory Failure and Shock |
| HCC85 | Congestive Heart Failure |
| HCC86 | Acute Myocardial Infarction |
| HCC87 | Unstable Angina and Other Acute Ischemic Heart Disease |
| HCC88 | Angina Pectoris |
| HCC96 | Specified Heart Arrhythmias |
| HCC99 | Cerebral Hemorrhage |
| HCC100 | Ischemic or Unspecified Stroke |
| HCC103 | Hemiplegia/Hemiparesis |
| HCC104 | Monoplegia, Other Paralytic Syndromes |
| HCC106 | Atherosclerosis of the Extremities with Ulceration or Gangrene |
| HCC107 | Vascular Disease with Complications |
| HCC108 | Vascular Disease |
| HCC110 | Cystic Fibrosis |
| HCC111 | Chronic Obstructive Pulmonary Disease |
| HCC112 | Fibrosis of Lung and Other Chronic Lung Disorders |
| HCC114 | Aspiration and Specified Bacterial Pneumonias |
| HCC115 | Pneumococcal Pneumonia, Empyema, Lung Abscess |
| HCC122 | Proliferative Diabetic Retinopathy and Vitreous Hemorrhage |
| HCC124 | Exudative Macular Degeneration |
| HCC134 | Dialysis Status |
| HCC135 | Acute Renal Failure |
| HCC136 | Chronic Kidney Disease, Stage 5 |
| HCC137 | Chronic Kidney Disease, Severe (Stage 4) |
| HCC157 | Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone |
| HCC158 | Pressure Ulcer of Skin with Full Thickness Skin Loss |
| HCC161 | Chronic Ulcer of Skin, Except Pressure |
| HCC162 | Severe Skin Burn or Condition |
| HCC166 | Severe Head Injury |
| HCC167 | Major Head Injury |
| HCC169 | Vertebral Fractures without Spinal Cord Injury |
| HCC170 | Hip Fracture/Dislocation |
| HCC173 | Traumatic Amputations and Complications |
| HCC176 | Complications of Specified Implanted Device or Graft |
| HCC186 | Major Organ Transplant or Replacement Status |
| HCC188 | Artificial Openings for Feeding or Elimination |
| HCC189 | Amputation Status, Lower Limb/Amputation Complications |
CMS-HCC Version 24 (V24)
| HCC | Description |
|---|---|
| HCC1 | HIV/AIDS |
| HCC2 | Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock |
| HCC6 | Opportunistic Infections |
| HCC8 | Metastatic Cancer and Acute Leukemia |
| HCC9 | Lung and Other Severe Cancers |
| HCC10 | Lymphoma and Other Cancers |
| HCC11 | Colorectal, Bladder, and Other Cancers |
| HCC12 | Breast, Prostate, and Other Cancers and Tumors |
| HCC17 | Diabetes with Acute Complications |
| HCC18 | Diabetes with Chronic Complications |
| HCC19 | Diabetes without Complication |
| HCC21 | Protein-Calorie Malnutrition |
| HCC22 | Morbid Obesity |
| HCC23 | Other Significant Endocrine and Metabolic Disorders |
| HCC27 | End-Stage Liver Disease |
| HCC28 | Cirrhosis of Liver |
| HCC29 | Chronic Hepatitis |
| HCC33 | Intestinal Obstruction/Perforation |
| HCC34 | Chronic Pancreatitis |
| HCC35 | Inflammatory Bowel Disease |
| HCC39 | Bone/Joint/Muscle Infections/Necrosis |
| HCC40 | Rheumatoid Arthritis and Inflammatory Connective Tissue Disease |
| HCC46 | Severe Hematological Disorders |
| HCC47 | Disorders of Immunity |
| HCC48 | Coagulation Defects and Other Specified Hematological Disorders |
| HCC51 | Dementia With Complications |
| HCC52 | Dementia Without Complication |
| HCC54 | Substance Use with Psychotic Complications |
| HCC55 | Substance Use Disorder, Moderate/Severe, or Substance Use with Complications |
| HCC56 | Substance Use Disorder, Mild, Except Alcohol and Cannabis |
| HCC57 | Schizophrenia |
| HCC58 | Reactive and Unspecified Psychosis |
| HCC59 | Major Depressive, Bipolar, and Paranoid Disorders |
| HCC60 | Personality Disorders |
| HCC70 | Quadriplegia |
| HCC71 | Paraplegia |
| HCC72 | Spinal Cord Disorders/Injuries |
| HCC73 | Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease |
| HCC74 | Cerebral Palsy |
| HCC75 | Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy |
| HCC76 | Muscular Dystrophy |
| HCC77 | Multiple Sclerosis |
| HCC78 | Parkinson's and Huntington's Diseases |
| HCC79 | Seizure Disorders and Convulsions |
| HCC80 | Coma, Brain Compression/Anoxic Damage |
| HCC82 | Respirator Dependence/Tracheostomy Status |
| HCC83 | Respiratory Arrest |
| HCC84 | Cardio-Respiratory Failure and Shock |
| HCC85 | Congestive Heart Failure |
| HCC86 | Acute Myocardial Infarction |
| HCC87 | Unstable Angina and Other Acute Ischemic Heart Disease |
| HCC88 | Angina Pectoris |
| HCC96 | Specified Heart Arrhythmias |
| HCC99 | Intracranial Hemorrhage |
| HCC100 | Ischemic or Unspecified Stroke |
| HCC103 | Hemiplegia/Hemiparesis |
| HCC104 | Monoplegia, Other Paralytic Syndromes |
| HCC106 | Atherosclerosis of the Extremities with Ulceration or Gangrene |
| HCC107 | Vascular Disease with Complications |
| HCC108 | Vascular Disease |
| HCC110 | Cystic Fibrosis |
| HCC111 | Chronic Obstructive Pulmonary Disease |
| HCC112 | Fibrosis of Lung and Other Chronic Lung Disorders |
| HCC114 | Aspiration and Specified Bacterial Pneumonias |
| HCC115 | Pneumococcal Pneumonia, Empyema, Lung Abscess |
| HCC122 | Proliferative Diabetic Retinopathy and Vitreous Hemorrhage |
| HCC124 | Exudative Macular Degeneration |
| HCC134 | Dialysis Status |
| HCC135 | Acute Renal Failure |
| HCC136 | Chronic Kidney Disease, Stage 5 |
| HCC137 | Chronic Kidney Disease, Severe (Stage 4) |
| HCC138 | Chronic Kidney Disease, Moderate (Stage 3) |
| HCC157 | Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone |
| HCC158 | Pressure Ulcer of Skin with Full Thickness Skin Loss |
| HCC159 | Pressure Ulcer of Skin with Partial Thickness Skin Loss |
| HCC161 | Chronic Ulcer of Skin, Except Pressure |
| HCC162 | Severe Skin Burn or Condition |
| HCC166 | Severe Head Injury |
| HCC167 | Major Head Injury |
| HCC169 | Vertebral Fractures without Spinal Cord Injury |
| HCC170 | Hip Fracture/Dislocation |
| HCC173 | Traumatic Amputations and Complications |
| HCC176 | Complications of Specified Implanted Device or Graft |
| HCC186 | Major Organ Transplant or Replacement Status |
| HCC188 | Artificial Openings for Feeding or Elimination |
| HCC189 | Amputation Status, Lower Limb/Amputation Complications |
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