coding-hcc-risk-adjustment
Maps chronic conditions extracted by OpenMed to CMS-HCC V28 risk-adjustment categories and estimates a RAF (Risk Adjustment Factor) score as decision support. Use when the user wants to surface risk-adjustable diagnoses from notes, map ICD-10-CM codes to HCC categories, estimate or reconcile a patient/panel RAF, find suspected-but-undocumented HCCs, or check MEAT documentation support. Trigger keywords: HCC, CMS-HCC, V28, RAF score, risk adjustment, Medicare Advantage, hierarchical condition category, MEAT, recapture, suspect HCC, RADV. Pairs after OpenMed NER + ICD-10 coding: consume Disease/
npx skills add maziyarpanahi/openmed --skill coding-hcc-risk-adjustment --agent claude-code
Same command for any agent — swap --agent for codex, cursor, copilot.
Weekly change comes from our own snapshots, not the repository page — it measures attention, not adoption.
# Mapping conditions to CMS-HCC V28 and estimating RAF Surface and risk-adjust the chronic conditions OpenMed extracts by mapping them to **CMS-HCC** categories (the **V28** model, phasing in for payment years 2024–2026) and estimating a **RAF** (Risk Adjustment Factor) score. CMS pays Medicare Advantage plans based on RAF, so accurate, *documented* capture of chronic disease matters — and much of that signal lives in the **narrative note**, exactly what OpenMed reads. This is **decision support for coders/clinicians**, not autonomous coding. The output is "candidate HCCs + estimated RAF + the documentation that supports (or fails to support) each one," for human validation. CMS-HCC crosswalks (ICD-10-CM → HCC) and the category coefficients are **public** — CMS publishes them annually. Nothing restricted is bundled. ## When to use - You want to **find risk-adjustable diagnoses** mentioned in a note that may not be on the coded problem list ("suspect HCCs" / recapture). - You need to **map ICD-10-CM codes to V28 HCCs** and apply the hierarchy. - You want an **estimated RAF** for a patient or panel for review. - You need to check whether a diagnosis has **MEAT** support (Monitored, E
- When to use
- Quick start (public CMS crosswalk + coefficients)
- Workflow
- Hand-off from OpenMed
- Edge cases & gotchas
- Standards & references
What does the coding-hcc-risk-adjustment skill do?
Maps chronic conditions extracted by OpenMed to CMS-HCC V28 risk-adjustment categories and estimates a RAF (Risk Adjustment Factor) score as decision support. Use when the user wants to surface risk-adjustable diagnoses from notes, map ICD-10-CM codes to HCC categories, estimate or reconcile a patient/panel RAF, find suspected-but-undocumented HCCs, or check MEAT documentation support. Trigger keywords: HCC, CMS-HCC, V28, RAF score, risk adjustment, Medicare Advantage, hierarchical condition category, MEAT, recapture, suspect HCC, RADV. Pairs after OpenMed NER + ICD-10 coding: consume Disease/
How do I install it?
Run `npx skills add maziyarpanahi/openmed --skill coding-hcc-risk-adjustment --agent claude-code` — it drops the skill into your project so the agent can pick it up. Swap the --agent value for codex, cursor or copilot if you use one of those.
Where does this skill come from?
From maziyarpanahi/openmed, a repository with 4,851 stars. We read it straight from the repository tree rather than a submitted listing, so what you see here is what is actually published.
Is a popular skill a good skill?
Not necessarily. Stars measure attention, not adoption — a repository can trend for a week and be abandoned. That is why we show the weekly change from our own snapshots next to the total, instead of a single flattering number.