Risk adjusted diagnoses are classified into hierarchical condition categories (HCCs). Some HCCs are in a hierarchy. Imagine the HCCs on a ladder, if you will. As you climb up the HCC ladder, the HCCs on the lower rungs are ‘replaced’ by the HCCs on the higher rungs. Here are some examples:

• HCC 19 – if this is the only one reported, it is included in the payment
• HCC 18 – if 19 and 18 are reported, 19 is dropped and only 18 is included in the payment
• HCC 17 – if 19, 18 & 17 are reported, 19 & 18 are dropped and only 17 is included in the payment
• HCC 16 – if 19 18, 17 & 16 are reported, 19, 18 & 17 are dropped and only 16 is included in the payment
• HCC 15 – if 19 18, 17, 16 & 15 are reported, 19 18, 17 & 16 are dropped and only 15 is included in the payment