Risk Adjustment — Pipeline Skill

Overview

Provide deterministic, copy-paste-ready Python and SQL code for CMS-HCC risk adjustment: ICD-10-to-HCC crosswalk, hierarchy resolution, RAF score calculation, and coding gap identification from Rx/lab proxies.

Usage

• Apply ICD-10-to-HCC crosswalk and resolve disease hierarchies programmatically
• Calculate member-level RAF scores and identify coding gaps from Rx/lab proxies

Core Concepts

Response Format