HL7 Terminology (THO)
3.1.5 - Continuous Process Integration (ci build) World

HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This is not an authorized publication; it is the continuous build for version 3.1.5). This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

NamingSystem: CMS Hierarchical Condition Categories

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.

Summary

Defining URLhttp://terminology.hl7.org/NamingSystem/cmshcc
NameCMSHCC
Statusactive
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.

PublisherCenters for Medicare & Medicaid Services

Identifiers

TypeValuePreferredPeriod
URIhttp://terminology.hl7.org/CodeSystem/cmshcctrue2021-12-02 --> (ongoing)

History

DateActionCustodianAuthorComment
2022-01-28createHTAJessica BotaAdd CMS Hierarchical Condition Categories per HTA; up-268