D86.3: Sarcoidosis of skin

Risk adjustment

D86.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 387 Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders0.406 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

D86.3 is named in 19 Medicare coverage policies: 19 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A52423Billing and Coding: Infliximab and biosimilars
• A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
• A56416Billing and Coding: Assays for Vitamins and Metabolic Function
• A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing