Description: In this session we will review the relationship between Hierarchical Condition Categories (HCC) coding and Risk Adjustment. The risk adjustment model was initially created to assist in estimating future health care costs for Medicare Advantage plan patients. But over the last decade, the value-based mindset has evolved to include risk adjustment and HCC coding plays a key role in that transition.

You will leave with an understanding of the history of HCC coding and risk adjustments, the HCC reimbursement methodology and how this correlates with the risk adjustment factor (RAF). Centers for Medicare and Medicaid (CMS) HCC reporting rules and the RADV audit process along with pertinent ICD-10 coding guidelines and key documentation issues that impact your HCC coding. Also included will be a look into how accurately capturing HCC’s can assist in elevating your facilities Medicare Star Rating.

This session will offer HCC information for both professional coders and explain why facility coders need to be more aware of the importance of HCC codes.

Date: This was presented as part of OHIMA's 2022 "Hybrid" Coding Seminar - September 29, 2022
Duration: 1 hour

Speaker: Angela James, MBA, RHIA, CCS, is a Health Information Management Compliance Manager with a passion for finding innovative ways to navigate the ever-changing world of healthcare in a pay for performance environment. She has over 20 years’ experience in healthcare, working in all aspects of the revenue cycle. Her career ranges from physician’s office registration to facility billing, with a primary focus on facility coding, compliance, education, and audits. Angie earned her BS in Health Information Administration from the University of Cincinnati and MBA at Thomas More University.  She actively serves on the advisory committee for the Health Information Management Department of Gateway Community and Technical College.

Click here to register for this webinar!

Cost: $25 Members / $35 Non-Members
1 AHIMA CEU*
Domain: Revenue Cycle Management

*AHIMA CEUs are also accepted by the AAPC! Check eligibility on the AAPC website.