A Detailed Guide On HCC Coding

1
A Detailed Guide On HCC Coding
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
2
A Detailed Guide On HCC Coding
In 2004, the Centres for Medicare and Medicaid
Services (CMS) launched the Hierarchical
Condition Category (HCC)code set. While
approaching its 20th anniversary, HCC coding is
becoming more common as healthcare shifts to
value-based payment models, a change that has
been actively pursued over the last decade. HCC,
as it is colloquially known, was created to
estimate and possibly predict a patients
healthcare costs over the course of his or her
life. A Guide on HCC Coding requires a long-term
perspective on multiple conditions, factors, and
determinants that may affect their individual
prognosis over many months or years. HCC codes
are directly related to ICD-10 codes
approximately 10,000 ICD-10 diagnosis codes out
of 70,000 diagnoses are directly related to at
least one of the 86 HCCs. HCC coefficients vary
depending on the patient category.
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
3
An Overview of the HCC Model
Based on the patients demographics and
diagnoses, the HCC model assigns a Risk
Adjustment Factor (RAF) score, which is a
relative measure of how expensive that patient is
expected to be. As healthy patients have a
lower-than-average RAF score, revenue from
insurance premiums is transferred from healthy
patients to patients with higher-than-average RAF
scores. According to the American Academy of
Family Physicians, hierarchical condition
category coding helps communicate patient
complexity and paint a picture of the whole
patient, allowing for appropriate quality and
cost performance measurement. In fact, reporting
a comprehensive picture of the risk adjustment
factor improves patient score accuracy and,
ideally, reduces the need to request medical
records or audit providers claims.
HTTPS//WWW.24MEDICALBILLINGSERVICES.COM/
4
Why is HCC coding important?
Hierarchical condition category coding is
designed to help determine patient care and
long-term health complexity while also painting
a picture of the entire patient. Painting a
complete picture of a patients health
necessitate more than just codes and technology,
but also expertise and analysis. Healthcare
professionals, for instance, should be persuaded
to review the entire patient record, looking for
any potential social determinants of health
(SDoH) that could affect the value of the care
provided (as in value-based care). HCCs use data
collected from patient encounters that have been
notated and coded to estimate predicted costs for
individuals over time in insurance, this could
be the next year or more of coverage. These
projections are based on the previous 12 months.
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
5
How can 24/7 Medical Billing Services assist you?
Capturing HCC diagnoses across the continuum of
care to reflect the total disease burden of a
patient population benefits not only the patient
but also physicians and payers. To achieve this
goal, providers and medical coders must stay
current on best practices and be educated on HCC.
When done correctly, HCC streamlines the process,
resulting in clean claims and quick
reimbursements. 24/7 Medical Billing Services
holds a team of well-trained and experienced HCC
coders who are responsible for assigning
appropriate diagnosis codes and CDI specialized
to review all clinical documentation for
completeness and accuracy. They also ensure
thorough risk adjustment evaluation for each
record in the best interests of the patient,
provider, and payer.
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
6
About Us
We are a medical billing company that offers
24/7 Medical Billing Services and support
physicians, hospitals, medical institutions and
group practices with our end to end medical
billing solutions. We help you earn more revenue
with our quick and affordable services. Our
customized Revenue Cycle Management (RCM)
solutions allow physicians to attract additional
revenue and reduce administrative burden or
losses.
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
7
Contact Us
Media Contact 24/7 Medical Billing
Services Georgia 3001 Greenfield Drive, Marietta
GA 30068 Ohio 28405 Osborn Road, Cleveland, OH
44140 Texas 2028 E Ben White Blvd, 240-1030
Austin TX, 78741 Delaware 16192 Coastal Highway,
Lewes, Delaware 19958, United States Phone no /
Fax [phone]
Email us info_at_247medicalbillingservices.com
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/