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Apply HCC Rules

Source: R/hierarchies.R
hierarchies.Rd

Applies hierarchical rules to a set of CCs based on the selected model version.

Usage

hierarchies(cc, model = "C28", year = 2025)

icd_to_cc(icd = NULL, model = "C28", year = 2025, simplify = FALSE)

Arguments

cc

<int> Set of currently active CCs

model

<chr> Model name, default is "C28"; one of:

  • C22: CMS-HCC Model V22

  • C24: CMS-HCC Model V24

  • C28: CMS-HCC Model V28

  • D21: CMS-HCC ESRD Model V21

  • D24: CMS-HCC ESRD Model V24

  • R05: RxHCC Model V05

  • R08: RxHCC Model V08

year

<int> 2025 or 2026; default is 2025

icd

<chr> ICD-10 diagnosis code(s)

simplify

<lgl> Return a named list; default is FALSE

Value

An <int> vector; one of:

  • CCs mapped to diagnosis codes

  • CCs after applying hierarchies

  • Empty vector, indicating the input CCs do not exist in the model/year

Examples

hierarchies(17:19)
#> [1] 17
hierarchies(18:19)
#> [1] 18
hierarchies(223L)
#> integer(0)
hierarchies(c(221L, 223L))
#> [1] 221 223
hierarchies(134:135, "D21")
#> [1] 135
hierarchies(134:137, "D24")
#> integer(0)
hierarchies(17L)
#> [1] 17

icd_to_cc("E119")
#> # A tibble: 1 × 4
#>    year icd_code    cc model_name       
#>   <int> <chr>    <int> <chr>            
#> 1  2025 E119        38 CMS-HCC Model V28
icd_to_cc("E119", "C24")
#> # A tibble: 1 × 4
#>    year icd_code    cc model_name       
#>   <int> <chr>    <int> <chr>            
#> 1  2025 E119        19 CMS-HCC Model V24
icd_to_cc("E119", "D21")
#> # A tibble: 1 × 4
#>    year icd_code    cc model_name            
#>   <int> <chr>    <int> <chr>                 
#> 1  2025 E119        19 CMS-HCC ESRD Model V21
icd_to_cc("I5022")
#> # A tibble: 1 × 4
#>    year icd_code    cc model_name       
#>   <int> <chr>    <int> <chr>            
#> 1  2025 I5022      226 CMS-HCC Model V28
icd_to_cc(c("E103213", "I5022", "Z9999"))
#> # A tibble: 3 × 4
#>    year icd_code    cc model_name       
#>   <int> <chr>    <int> <chr>            
#> 1  2025 E103213     37 CMS-HCC Model V28
#> 2  2025 I5022      226 CMS-HCC Model V28
#> 3  2025 E103213    298 CMS-HCC Model V28