Description: In the complex world of healthcare coding, Hierarchical Condition Category (HCC) coding plays a pivotal role in patient risk adjustment, reimbursement, and care quality. This session will explore how facilities and physician coders approach HCC coding, highlighting each side's unique perspectives, challenges, and priorities. From the facility's viewpoint, HCC coding is essential for accurate risk adjustment, proper reimbursement, and ensuring compliance with regulatory standards. Facilities need to capture a comprehensive picture of the patient population to maintain financial stability while providing quality care. From the physician coder's perspective, accurate HCC coding is crucial for reflecting the true severity of illness, supporting clinical decision-making, and ensuring that diagnoses are fully documented for the correct reimbursement. Physician coders are tasked with translating clinical narratives into precise codes that accurately reflect patient conditions, often under tight time constraints. By exploring these distinct perspectives, attendees will understand why HCC coding matters to both sides, the potential consequences of misalignment, and how collaboration between facility teams and physician coders can optimize coding accuracy. The session will provide actionable insights on bridging communication gaps, improving documentation practices, and achieving a unified approach to HCC coding that benefits both patient care and organizational goals.

Learning Objectives:

• Compare and contrast the perspectives of facilities and physician coders on HCC coding, focusing on their unique priorities and challenges in capturing accurate diagnoses for risk adjustment and reimbursement.
• Identify the consequences of misalignment between facility teams and physician coders in HCC coding and explore strategies to overcome common coding errors and documentation gaps.
• Develop actionable strategies for enhancing collaboration between facility staff and physician coders, focusing on improving documentation practices and achieving accurate HCC coding for better patient care and financial outcomes.

Webinar Publish Date: This was presented as part of the OHIMA 2025 Annual Meeting & Trade Show - March 19, 2025.
Duration: 1 hour

Speaker: Angie James, MBA, RHIA, CCS, is a Senior Manager of Coding and CDI with a passion for finding innovative ways to navigate the ever-changing world of healthcare in a pay for performance environment. She has over 25 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 OHIMA Executive Board, President of SWOHIMA and sits on the advisory committee for the Health Information Management Department of Gateway Community and Technical College.

Speaker:  Melissa Bell, CPC III, CRC, is a Coder Lead for The Christ Hospital Primary Care Physicians with 25 years of medical coding and billing experience from the payer side to billing management in private practice to professional coding. She is currently focusing on Risk Adjustment and documentation education to ensure a successful transition from fee-for-service to value-based care.

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.