HL7 Terminology (THO)
5.0.0 - Publication
HL7 Terminology (THO)
5.0.0 - Publication
This page is part of the HL7 Terminology (v5.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions 
| Official URL: http://terminology.hl7.org/NamingSystem/cmshcc | Version: | |||
| Active as of 2021-12-02 | Responsible: Centers for Medicare & Medicaid Services | Computable Name: CMSHCC | ||
The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories that predict costs well. The condition categories are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the condition categories to capture the most costly diagnoses. Hierarchy logic is imposed on certain condition categories to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC.
For more information, see https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Risk-Adjustors.
The CMS HCCs are in the public domain and are free to use without restriction.
| Defining URL | http://terminology.hl7.org/NamingSystem/cmshcc |
| Name | CMSHCC |
| Status | active |
| Definition | The CMS-HCC model uses more than 9,000 ICD-10-CM codes, which are mapped to condition categories that predict costs well. The condition categories are based on diagnoses clinically related to one another and with similar predicted cost implications. Hierarchies are imposed on the condition categories to capture the most costly diagnoses. Hierarchy logic is imposed on certain condition categories to account for different hierarchical costs, thus, the term Hierarchical Condition Category, or HCC. For more information, see https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Risk-Adjustors. The CMS HCCs are in the public domain and are free to use without restriction. |
| Publisher | Centers for Medicare & Medicaid Services |
| Type | Value | Preferred | Period |
| URI | http://terminology.hl7.org/CodeSystem/cmshcc | true | 2021-12-02 --> (ongoing) |
History
| Date | Action | Author | Custodian | Comment |
| 2022-01-28 | create | Jessica Bota | HTA | Add CMS Hierarchical Condition Categories per HTA; UP-268 |
IG © 2020+ HL7 International - Vocabulary Work Group. Package hl7.terminology#5.0.0 based on FHIR 4.0.1. Generated 2022-11-04
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