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2F-Documentation for HCC Codes-REVISED FROM …

1 HCC CODINGA documentation StrategyLynn Myers MD, CPC, CHCA genda Terminology History of Medicare Risk Adjustment Coding Strategy documentation Strategy22 Terminology HCC- hierarchical Condition categories -usuallychronic conditions used to create a risk adjustment methodology Rx HCC- Some HCC codes adjust risk due to prescription burden of disease CMS-Centers for Medicare & Medicaid Services Medicare Advantage (Managed Medicare)-A method of helping CMS budget for the cost of caring for populations of patients RAF-Risk Adjustment Factor-assessing the acuity of illness based upon reported ICD-9 codes & demographics, which ultimately is reflected in reimbursement-HCC codes are payment multipliers.

2 Terminology • HCC-Hierarchical Condition Categories-usually chronic conditions used to create a risk adjustment methodology • Rx HCC- Some HCC codes adjust risk due to prescription

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  Conditions, Documentation, Hierarchical, Categories, Hierarchical condition categories

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