Hierarchical Condition Categories (HCCs) have been used in the Centers for Medicare & Medicaid Services (CMS) risk adjustment payment model since 2004. That’s 17 years! More and more HIM professionals […]

Audits of Hierarchical Condition Categories (HCCs) have been performed for years as a way for Part C vendors (Medicare Advantage Organizations) to identify and support patients with complex needs. Higher […]

Far too often, healthcare organizations treat planning and execution as two separate processes which are intended to achieve a larger goal. Leadership makes plans and departments and workers are told […]

In my previous blog, “Demystifying Medicare Risk Adjustment,” I introduced the model that the Centers for Medicare and Medicaid Services (CMS) uses to predict future Medicare Advantage health expenditures—the CMS-HCC […]

After attending an AAPC presentation last year, I published a blog about HCC coding. Since then, I have continued to dive into the world of HCCs. To follow up on […]

As the activity around the forthcoming 2020 election period is heating up, and with it, talk of “Medicare-For-All” options, I thought I’d begin my contribution to the Inside Angle blog […]

Diagnostic exams are an important way for hospitals and health systems to capture more complete, longitudinal patient information. Complete coding of diagnostic exams supports population health management and HCC reporting. […]

Happy New Year everyone! I am terrible at New Year’s resolutions, but I did make one this year that I hope to stick to: I want to increase my intake […]

In my previous blog, I took a hard look at the impact of mental health and substance abuse on hospital readmissions, especially the torrent of patients with these issues coming […]

A hot topic in health care today is Hierarchical Condition Categories (HCCs). At the last local AAPC chapter meeting I attended, we had a guest speaker who discussed HCCs in […]

HCCs are a “problem.” By that I mean no organization can ignore the impact of HCCs. No CDI specialist, HIM professional, quality specialist, provider or billing auditor can remain uneducated […]

The Official ICD Coding Guidelines state that a condition must be present at the time of the encounter, affect patient care or management and be clearly documented in order to […]