Difference between revisions of "CMS-HCC Disease Coefficients"
From PatientRecovery
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These are the disease coefficients component of the [[CMS-HCC Risk Adjustments]] | These are the disease coefficients component of the [[CMS-HCC Risk Adjustments]] | ||
| − | The relative risk scores in this table were calculated by dividing the parameter estimates by the Part C national average predicted expenditures | + | The relative risk scores in this table were calculated by dividing the parameter estimates by the Part C national average predicted expenditures of $9,276.26. |
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
!style="background: #e3e3e3;"|Disease Coefficients | !style="background: #e3e3e3;"|Disease Coefficients | ||
Latest revision as of 14:15, 23 April 2014
These are the disease coefficients component of the CMS-HCC Risk Adjustments
The relative risk scores in this table were calculated by dividing the parameter estimates by the Part C national average predicted expenditures of $9,276.26.
| Disease Coefficients | Description Label | Community Factor | Institutional Factor |
|---|---|---|---|
| HCC1 | HIV/AIDS | 0.470 | 1.904 |
| HCC2 | Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock | 0.535 | 0.575 |
| HCC6 | Opportunistic Infections | 0.440 | 0.344 |
| HCC8 | Metastatic Cancer and Acute Leukemia | 2.484 | 1.203 |
| HCC9 | Lung and Other Severe Cancers | 0.973 | 0.674 |
| HCC10 | Lymphoma and Other Cancers | 0.672 | 0.412 |
| HCC11 | Colorectal, Bladder, and Other Cancers | 0.317 | 0.296 |
| HCC12 | Breast, Prostate, and Other Cancers and Tumors | 0.154 | 0.198 |
| HCC17 | Diabetes with Acute Complications | 0.368 | 0.474 |
| HCC18 | Diabetes with Chronic Complications | 0.368 | 0.474 |
| HCC19 | Diabetes without Complications | 0.118 | 0.182 |
| HCC21 | Protein-Calorie Malnutrition | 0.713 | 0.399 |
| HCC22 | Morbid Obesity | 0.365 | 0.579 |
| HCC23 | Other Significant Endocrine and Metabolic Disorders | 0.245 | 0.282 |
| HCC27 | End-Stage Liver Disease | 0.923 | 1.083 |
| HCC28 | Cirrhosis of Liver | 0.399 | 0.351 |
| HCC29 | Chronic Hepatitis | 0.251 | 0.351 |
| HCC33 | Intestinal Obstruction/Perforation | 0.310 | 0.384 |
| HCC34 | Chronic Pancreatitis | 0.286 | 0.095 |
| HCC35 | Inflammatory Bowel Disease | 0.302 | 0.318 |
| HCC39 | Bone/Joint/Muscle Infections/Necrosis | 0.498 | 0.340 |
| HCC40 | Rheumatoid Arthritis and Inflammatory Connective Tissue Disease | 0.374 | 0.351 |
| HCC46 | Severe Hematological Disorders | 1.136 | 0.794 |
| HCC47 | Disorders of Immunity | 0.521 | 0.519 |
| HCC48 | Coagulation Defects and Other Specific Hematological Disorders | 0.252 | 0.164 |
| HCC54 | Drug/Alcohol Psychosis | 0.420 | 0.053 |
| HCC55 | Drug/Alcohol Dependence | 0.420 | 0.053 |
| HCC57 | Schizophrenia | 0.490 | 0.311 |
| HCC58 | Major Depressive, Bipolar, and Paranoid Disorders | 0.330 | 0.311 |
| HCC70 | Quadriplegia | 1.234 | 0.650 |
| HCC71 | Paraplegia | 1.052 | 0.539 |
| HCC72 | Spinal Cord Disorders/Injuries | 0.509 | 0.280 |
| HCC73 | Amyotrophic Lateral Sclerosis and Other Motor Neuron Disease | 0.958 | 0.367 |
| HCC74 | Cerebral Palsy | 0.045 | - |
| HCC75 | Polyneuropathy | 0.408 | 0.300 |
| HCC76 | Muscular Dystrophy | 0.565 | 0.215 |
| HCC77 | Multiple Sclerosis | 0.556 | - |
| HCC78 | Parkinson's and Huntington's Diseases | 0.691 | 0.173 |
| HCC79 | Seizure Disorders and Convulsions | 0.284 | 0.144 |
| HCC80 | Coma, Brain Compression/Anoxic Damage | 0.570 | 0.104 |
| HCC82 | Respirator Dependence/Tracheostomy Status | 1.520 | 1.769 |
| HCC83 | Respiratory Arrest | 0.802 | 1.169 |
| HCC84 | Cardio-Respiratory Failure and Shock | 0.329 | 0.442 |
| HCC85 | Congestive Heart Failure | 0.368 | 0.229 |
| HCC86 | Acute Myocardial Infarction | 0.275 | 0.515 |
| HCC87 | Unstable Angina and Other Acute Ischemic Heart Disease | 0.258 | 0.515 |
| HCC88 | Angina Pectoris | 0.141 | 0.474 |
| HCC96 | Specified Heart Arrhythmias | 0.295 | 0.262 |
| HCC99 | Cerebral Hemorrhage | 0.339 | 0.216 |
| HCC100 | Ischemic or Unspecified Stroke | 0.317 | 0.216 |
| HCC103 | Hemiplegia/Hemiparesis | 0.581 | 0.061 |
| HCC104 | Monoplegia, Other Paralytic Syndromes | 0.396 | 0.061 |
| HCC106 | Atherosclerosis of the Extremities with Ulceration or Gangrene | 1.413 | 0.886 |
| HCC107 | Vascular Disease with Complications | 0.410 | 0.301 |
| HCC108 | Vascular Disease | 0.299 | 0.107 |
| HCC110 | Cystic Fibrosis | 0.417 | 0.364 |
| HCC111 | Chronic Obstructive Pulmonary Disease | 0.346 | 0.364 |
| HCC112 | Fibrosis of Lung and Other Chronic Lung Disorders | 0.274 | 0.260 |
| HCC114 | Aspiration and Specified Bacterial Pneumonias | 0.672 | 0.285 |
| HCC115 | Pneumococcal Pneumonia, Emphysema, Lung Abscess | 0.200 | 0.285 |
| HCC122 | Proliferative Diabetic Retinopathy and Vitreous Hemorrhage | 0.203 | 0.433 |
| HCC124 | Exudative Macular Degeneration | 0.335 | 0.166 |
| HCC134 | Dialysis Status | 0.476 | 0.509 |
| HCC135 | Acute Renal Failure | 0.476 | 0.509 |
| HCC136 | Chronic Kidney Disease, Stage 5 | 0.224 | 0.509 |
| HCC137 | Chronic Kidney Disease, Severe (Stage 4) | 0.224 | 0.294 |
| HCC157 | Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone | 2.488 | 1.050 |
| HCC158 | Pressure Ulcer of Skin with Full Thickness Skin Loss | 1.338 | 0.435 |
| HCC161 | Chronic Ulcer of Skin, Except Pressure | 0.536 | 0.311 |
| HCC162 | Severe Skin Burn or Condition | 0.411 | 0.327 |
| HCC166 | Severe Head Injury | 0.570 | 0.104 |
| HCC167 | Major Head Injury | 0.163 | - |
| HCC169 | Vertebral Fractures without Spinal Cord Injury | 0.497 | 0.228 |
| HCC170 | Hip Fracture/Dislocation | 0.446 | - |
| HCC173 | Traumatic Amputation and Complications | 0.265 | 0.122 |
| HCC176 | Complications of Specified Implanted Device or Graft | 0.556 | 0.522 |
| HCC186 | Major Organ Transplant or Replacement Status | 0.891 | 0.515 |
| HCC188 | Artificial Openings for Feeding or Elimination | 0.651 | 0.594 |
| HCC189 | Amputation Status, Lower Limb / Amputation Complications | 0.779 | 0.468 |
