How Do I Know If My Documentation Is Enough for HCC Coding? | Webinar

How Do I Know If My Documentation Is Enough for HCC Coding?

July 23, 2026 at 12:00 pm ET

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Please note: Registration closes at 12:00 pm the day before the event. If you miss the registration deadline, you can watch on-demand following the event.

Speaker Maria A. Mirt Sánchez, MD, MSc, CPC, CRC, CDEO

Providers consistently ask: "Is what I wrote enough?" This webinar answers that question directly, using the MEAT framework, real outpatient documentation examples, and the updated CMS-HCC Version 28 (V28) model fully in effect for CY 2026. From how the model calculates risk scores to what specific language in a note actually captures an HCC, every concept is grounded in current CMS standards and illustrated with the documentation patterns auditors see every day.

Attendees will learn exactly what qualifies as sufficient documentation for HCC capture in the outpatient setting: what MEAT requires, which conditions can no longer be coded as active after the acute phase resolves, and how V28's native ICD-10-CM structure means that specificity, systolic versus diastolic heart failure, CKD Stage 3a versus 3b, diabetes with its complications documented precisely, is now the mechanism of risk capture, not just a coding preference. The session also covers what RADV auditors actually look for in a medical record and the documentation gaps most likely to produce a failed review.

The session bridges clinical documentation and coding compliance through a physician's lens: practical, condition-specific, and built around the one-sentence documentation standard that separates a captured HCC from a missed risk adjustment opportunity. Attendees will leave with concrete language they can apply at the point of care, not abstract guidance, but the difference between "HTN stable" and "HTN, stable, continue lisinopril 10mg, BP 128/76 today", and the clinical and financial stakes of that distinction under V28.

Learning objectives

1. Apply the MEAT criteria framework to evaluate whether outpatient encounter documentation meets the standard required for HCC capture and RADV audit validation under the CMS-HCC V28 model.
2. Identify outpatient coding compliance rules governing conditions that cannot be coded as active in the office setting, including resolved acute conditions, uncertain diagnoses, and post-acute follow-up encounters, and select the correct ICD-10-CM codes for each scenario.
3. Distinguish V28 HCC model changes that require greater documentation specificity, including heart failure (systolic vs. diastolic), CKD staging (3a vs. 3b), and diabetes with complication combinations, and explain how documentation specificity directly determines risk score capture.

Who should attend

• Risk coders
• Billers
• Compliance professionals
• Administrators
• Chief Medical Officers

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