Risk adjustment prospective payment system used by Centers for Medicare and Medicaid Services (CMS) for managed care organizations (MCOs). It uses a hierarchical diagnosis classification system and other demographic adjusters to foretell costs and establish payment amounts for managed care services to Medicare beneficiaries.

Numerical order of diagnostic codes in which each digit beyond three digits adds information. See Box H-3 .Box H-3ALPHANUMERICAL CODES FOR ICD-10-CMFRACTURE OF UPPER LIMB (810-819)810 Fracture of clavicleIncludes: collar boneinterligamentous part of clavicleThe following fifth-digit subclassification is for use with category 810:0 unspecified partClavicle NOS1 sternal end of clavicle2 shaft of clavicle3 acromial end of clavicle 810.0ICD-10-CMS42.00 Closed fracture of clavicleS42.001 Closed fracture of right clavicleS42.002 Closed fracture of left clavicleS42.009 Closed fracture of clavicle, unspecified side