NBER

ICD HCC Crosswalk -- International Classification of Diseases to Hierarchical Condition Category Crosswalk

CMS implemented the Hierarchical Condition Categories (HCC) model in 2004 to adjust capitation payments to Medicare Advantage plans for the health expenditure risk of their enrollees.

CMS' Risk Adjustment materials include a lot of information such as HCC, RxHCC, HCC ESRD, and HCC PACE risk adjustment model documentation, coefficients, and other source materials. including a worked example.

Condition Category to ICD crosswalk files are also available.

Prescription drug Hierarchical Condition Category (RxHCC) info is available beginning 2006.

End-Stage Renal Disease (ESRD) and Program of All-Inclusive Care for the Elderly (PACE) info is avaialable starting 2012.

A collection of data sets of ICD9 titles is available.

The SAS, Stata, and CSV files are offered here with uniform file names and variable names to make the ICD HCC crosswalks a bit easier to use.

ICD HCC Crosswalk -- ICD RxHCC Crosswalk

Year
Stata
SAS
CSV
Source Materials
Description
ZIP
Excel
2019
dta
sas7bdat
csv
zip
xlsx
desc
2018
dta
sas7bdat
csv
zip
xlsx
desc
2017
dta
sas7bdat
csv
zip
xlsx
desc
2016
dta
sas7bdat
csv
zip
xls
desc
2015
CMS moved to ICD-10-CM diagnosis codes in the 2016 fiscal year which began October 1, 2015.
So, January 1 - September 30, 2015, ICD-9-CM codes were used,
and October 1, 2015 - December 31, 2015 ICD-10-CM codes are used.
2014
dta
sas7bdat
csv
zip
xls
desc
2013
dta
sas7bdat
csv
zip
xls
desc
2012
dta
sas7bdat
csv
zip
xls
desc
2011
dta
sas7bdat
csv
zip
xls
desc
2010
dta
sas7bdat
csv
zip
xls
desc
2009
dta
sas7bdat
csv
desc
2008
dta
sas7bdat
csv
desc
2007
dta
sas7bdat
csv
desc
2006
dta
sas7bdat
csv
desc
2005
dta
sas7bdat
csv
desc
2004
dta
sas7bdat
csv
desc

Contact data@nber.org with questions, comments, or suggestions.

Last Update: March 20, 2018 Created by Jean Roth August 1, 2014

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