Risk Adjustment Coding and HCC Guide

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Power up your Adjustment Coding and HCC Guide2018 Optum360, LLCiContentsIntroduction ........................................ ........................................ ........................................ ..... 1History and purpose of RAF ........................................ ........................................ ........................................ ...1Key Terms Definitions ........................................ ........................................ ........................................ .............3Acceptable provider types/SOS ........................................ ........................................ ....................................5The provider s role.

HCC 22 E66.2 Obesity hypoventilation syndrome (OHS) 0.273 No Yes Demographics 54-year-old, female, not Medicaid eligible 0.263 Yes Yes Total RAF 0.409 1.077 It is necessary to query the provider for additional information about the depression. There is insufficient documentation to code major depressive disorder.

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