A81.00: Creutzfeldt-Jakob disease, unspecified

Risk adjustment

A81.00 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 127 Dementia, Mild or Unspecified0.341 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

A81.00 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A56612Billing and Coding: CT of the Head
• A56868Billing and Coding: Outpatient Speech Language Pathology
• A57204Billing and Coding: MRI and CT Scans of the Head and Neck