Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Item Field Size Position Comment Description
68 HCC055 1 111 Set to "1" if applicable,
otherwise "0"
69 HCC057 1 112 Set to "1" if applicable,
otherwise "0"
70 HCC058 1 113 Set to "1" if applicable,
otherwise "0"
71 HCC070 1 114 Set to "1" if applicable,
otherwise "0"
72 HCC071 1 115 Set to "1" if applicable,
otherwise "0"
73 HCC072 1 116 Set to "1" if applicable,
otherwise "0"
74 HCC073 1 117 Set to "1" if applicable,
otherwise "0"
75 HCC074 1 118 Set to "1" if applicable,
otherwise "0"
76 HCC075 1 119 Set to "1" if applicable,
otherwise "0"
77 HCC076 1 120 Set to "1" if applicable,
otherwise "0"
78 HCC077 1 121 Set to "1" if applicable,
otherwise "0"
79 HCC078 1 122 Set to "1" if applicable,
otherwise "0"
80 HCC079 1 123 Set to "1" if applicable,
otherwise "0"
81 HCC080 1 124 Set to "1" if applicable,
otherwise "0"
82 HCC082 1 125 Set to "1" if applicable,
otherwise "0"
83 HCC083 1 126 Set to "1" if applicable,
otherwise "0"
84 HCC084 1 127 Set to "1" if applicable,
otherwise "0"
85 HCC085 1 128 Set to "1" if applicable,
otherwise "0"
86 HCC086 1 129 Set to "1" if applicable,
otherwise "0"
Drug/Alcohol Dependence
Schizophrenia
Major Depressive, Bipolar, and
Paranoid Disorders
Quadriplegia
Paraplegia
Spinal Cord Disorders/Injuries
Amyotrophic Lateral Sclerosis and
Other Motor Neuron Disease
Cerebral Palsy
Polyneuropathy
Muscular Dystrophy
Multiple Sclerosis
Parkinson’s and Huntington’s
Diseases
Seizure Disorders and Convulsions
Coma, Brain Compression/Anoxic
Damage
Respirator
Dependence/Tracheostomy Status
Respiratory Arrest
Cardio-Respiratory Failure and
Shock
Congestive Heart Failure
Acute Myocardial Infarction
December 28, 2012 F-65 Part C Risk Adjustment Model Output
Data File