HCC Coding Compliance

This week, Terry introduces a new ICD-10-CM topic of HCC (Hierarchical Condition Category) coding relies on ICD-10-CM coding to assign risk scores to patients. Each HCC is mapped to an ICD-10-CM code.

Along with demographic factors such as age and gender, insurance companies use HCC coding to assign patients a risk adjustment factor (RAF) score. Using algorithms, insurance companies can use a patient’s RAF score to predict costs for sick patients.

Terry also discusses the importance of HCC coding and why the OIG is looking at the accuracy or an FCA could be an issue.

Tune in for all of the details.

Subscribe and Listen

You can subscribe to our podcasts via:

[sharonkincaid]

I work for a large medical system that has a huge “always code list” that if documented anyplace in note (except problem list) we are to code it. Even if in for ear infection we capture their hypertension, dm, etc. I HATE IT!!!

[Girlwhatzdatea_]

I have a question where can I locate the materials that Terry is reading? Those are great points to reference when coding HCC