Medical practices are assessing the impact of the change in the HCC model from V24 to V28, a phased in change that begins in 2024. CMS pays … [Read more...]
What are Social Determinants of Health?
Question: Can you settle this question for our coding team? Are smoking and drinking considered Social Determinants of … [Read more...]
Coding Clinic Update, 2Q, 2023
Dr. Kennedy has generously allowed me to share his summary. He emphasizes that he is paraphrasing the recent advice in the spirit of “fair use” and we … [Read more...]
HCC Transition from V24 to V28 | Webinar
HCC Transition from V24 to V28 Recorded July 20, 2023 CMS is transitioning risk coding from the 2020 V24 model to V28 beginning in 2024. … [Read more...]
Compliance issues in ICD-10 coding for risk based contracts and HCCs
Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here’s an important excerpt. “Code all documented … [Read more...]
HCC diagnosis coding example: diabetes, hypertension, chronic kidney disease
If a picture is worth 1000 words, what’s an example worth? An example can show in a glance what it takes paragraphs to write and explain. The one … [Read more...]
HCC Coding for Medical Practices | Webinar
HCC Coding for Medical Practices Recorded April 15, 2021 The rules related to HCC coding in physician practices are found in the ICD-10 book … [Read more...]
Coding for diabetes in the HCC system | Reference Sheet
For medical practices who are part of an ACO, MSSP, or other Alternative Payment Model, understanding how to code accurately is critical to reporting … [Read more...]
Coding for hypertension in the HCC system | Reference Sheet
The code for hypertension was the first ICD-10-CM code I memorized, the year we all switched gears and learned the new system. This table lists the … [Read more...]
Five urban legends about risk-adjusted diagnosis coding
Originally published on kevinmd.com When I talk to medical practices about Hierarchical Condition Category (HCCs) and risk-adjusted diagnosis … [Read more...]
HCC’s in brief | The difference between CMS-HCC and HHS-HCC
Demographics and diagnoses Risk adjusted diagnosis coding is a model used to predict future health care costs based on demographics and diagnoses. It … [Read more...]
Diabetes coding in Hierarchical Condition Coding (HCC)
Diabetes is a common chronic condition, included in three distinct HCC categories Patients often have more than one chronic condition of the … [Read more...]
Depression coding and Hierarchical Condition Coding (HCC)
Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes the medical necessity for a service. At times, … [Read more...]
HCC coding: round up of chronic conditions
I saw on twitter recently that COPD was the third leading cause of death in the U.S. If it was on twitter, it must be true, right? This article … [Read more...]
Risk Coding for Medical Practices and Outpatient Services
Introduction to Risk Coding for Medical Practices and Outpatient Services Where do we find the rules for assigning diagnosis codes in medical … [Read more...]
Coding Guide – Risk Adjusted Diagnosis Coding for Medical Practices
Payment systems and reimbursement are ever-changing in healthcare and the rules of yesterday may or may not work tomorrow. Medical practices continue … [Read more...]
HCC diagnosis coding: Can you add a code from the past medical history?
This post describes rules for office/outpatient coding, not facility/DRG rules. Recently a fellow coder wrote to me about risk adjusted diagnosis … [Read more...]
What’s the difference between B20 and Z21? Which is right for positive HIV status?
In this post ICD-10-CM diagnosis coding for positive HIV status Update to HIV coding in 2022 Medical practice reimbursement for individual … [Read more...]