Risk Adjustment (RA) HCCs (Hierarchical Condition Categories) are a growing sector within the Medicare population, and no longer the domain of only physician practices. Hospital inpatient and outpatient areas contribute to HCCs, yet there is a lack of understanding of how RA works and how HCCs are obtained that can create coding and compliance risks. With the skyrocketing number of MA beneficiaries and increased compliance scrutiny surrounding RA HCCs, it's crucial that health information management (HIM) coding and clinical documentation integrity (CDI) professionals understand the requirements and rules for documentation, clinical coding for HCCs, and possess an ability to navigate HCCs. Register to attend this two-part educational series presented by HIM and CDI leader Gloryanne Bryant, and gain new knowledge and skills to address the challenges of the RA HCC coding world.
During Part I, Gloryanne solidifies your understanding of the foundational basics of HCCs with a review of the history and rationale for RA and Medicare Part C, explaining how payment is calculated and the use of risk scores. In addition, she'll cover the different components to the Star ratings that are tied to bonus payments for RA.
Part II drills down into the HCC details and specific documentation and ICD-10-CM codes. Gloryanne will walk through case examples and scenarios, providing much needed HCC and ICD-10-CM information for improving accuracy and compliance. She'll also provide tips on how to prepare for CMS RADV audits so that practices and organizations can be proactive rather than reactive.
Why This is Relevant:
There has been a huge growth of CMS MA Risk Adjustment, now around 24.1 million beneficiaries, and hospital inpatient and outpatient areas contribute to the diagnoses collected for HCCs. Yet, a lack of understanding of how RA works and how HCCs are obtained using ICD-10-CM codes exists for HIM coding and CDI professionals which can impact compliance. And now, there is additional documentation scrutiny from the OIG with HCCs and the associated ICD-10-CM codes so improving understanding and accuracy is crucial to maintaining compliance.
- Understand the history and purpose of Risk Adjustment, including the link between HCCs and ICD-10-CM coding
- Learn Medicare Advantage RA HCC requirements and key definitions
- Gain greater knowledge of the documentation issues and lack of specificity that can occur
- Enhance diagnostic coding skills through review of case scenarios and examples
- Improve ICD-10-CM coding and HCC accuracy
- Understand Risk Adjustment Factor Scores and the financial impact of certain HCCs
- Receive HCC documentation guidance and advice for capturing ICD-10-CM
- Learn tips on how to prepare for a CMS RADV audit and the greater federal scrutiny of clinical documentation and coding
Who Should Attend:
Outpatient and Inpatient coders, coding auditors and coding educators, HCC coding staff, clinical documentation integrity specialists (CDISs), coding compliance specialists and managers, hospital emergency department coders, compliance directors, physician office coding staff and revenue cycle managers.
Webcast Access Privileges: Only one login is allowed per webcast purchased. Discounted pricing for additional registrants is available. For more information about webcast pricing and requirements, click here.
*This discount may not be combined with any other discount or special offer.
**In addition to a 2-part series, these webcasts are offered individually. Each session is available on CD or on-demand following the live presentation. CDs ship 2 to 3 weeks after the webcast date.