CodingIntel

Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

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HCC diagnosis coding: what medical practices need to know about risk adjusted diagnosis coding

Recorded December 14, 2017

Risk coding is all the rage!  Are you up-to-date?

In fee-for-service medicine, physician services are paid based on the fee associated with that CPT® code, HCPCS code and modifiers. The diagnosis coding establishes the medical necessity for this service. With new payment models, diagnosis coding for physician services takes on added importance and affects future payments.

In this presentation from CodingIntel, we explain HCC coding for medical practices.

Accurate and complete diagnosis coding (along with utilization and quality) will affect incentive payments. Medical practices joining accountable care organizations, Medicare shared savings programs or entering into diagnosis risk-adjusted contracts with private payers need to review their diagnosis coding and many will need to make changes.

This presentation provides an overview for medical practices in the important concepts related to risk-adjusted diagnosis coding. As our healthcare system moves from volume to value, accurately reporting the severity of illness for individual patients becomes imperative.

Agenda for this webinar includes:

  • Overview of how physician services are paid in value contracts
  • Introduction to HCC diagnosis coding
  • Risk scores for frequently used conditions
  • Importance of specificity in chronic conditions
  • What status codes matter in risk coding

Learning Objectives:

  • Demonstrate knowledge of two key concepts of risk-adjusted diagnosis coding
  • Evaluate their own risk adjustment ICD-10 use of unspecified codes and use of status codes
  • Develop a plan to increase specificity in both primary care and specialty claims
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CodingIntel members get access to our entire library of coding resources, including guides on HCC risk adjustment, the RAF score and risk adjustment ICD-10 codes. Membership includes FREE access to all live webinars! If you miss one, you can watch on-demand anytime.

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Last revised October 12, 2020 - Betsy Nicoletti
Tags: diagnosis coding, HCC, physician coding, risk adjusted coding

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Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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