Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Software Code
Program Area: Risk Adjustment (RA)
Question: Which diagnosis codes are no longer eligible for the Risk Adjustment (RA) program based on the January 13, 2015 External Data Gathering Environment (EDGE) server reference data update?
Answer: The following diagnosis codes are no longer eligible for RA: 2865, 4251, 4440, 5163, 631 and 7473. The status of these diagnosis codes is consistent with the RA DIY software posted in June 2014.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 21, 2015
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