Coding for Chronic Conditions
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About this program
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The Centers for Disease Control and Prevention (CDC) reports that 6 in 10 adults in the United States have a chronic disease, and that 4 in 10 have two or more chronic diseases. Accurately coding for diagnostic and therapeutic services provided to these patients can be complex. If you are not accurately utilizing Coding for Chronic Conditions (CCM codes), you could be leaving dollars on the table. Attend this session and learn to successfully navigate these coding challenges.
Coders should be reporting chronic conditions as CMS Risk Adjustment (RA) and Hierarchical Condition Category (HCC) coding identifies individuals with serious or chronic illness and assigns a risk factor score. Originally developed for use by Medicare Advantage (MA) plans, HCCs are now used in a variety of value-based reimbursement (VBR) programs. HCC coding helps explain the complexity of the patient and paint a more complete picture of them and their illnesses.
Proper HCC coding and documentation can help eliminate gaps in care and ensure proper payments. When secondary diagnoses are not reported, then HCC’s are not captured for the claim, which can negatively impact quality measure statistics in addition to reimbursement. Coding expert, Libby Purser, will explain this complex reimbursement methodology in plain language and provide insight to help you gain a definitive understanding of all guidelines for coding chronic conditions.
How often can chronic diseases be coded and reported? When should history codes be used as secondary codes? What questions should coders ask prior to assigning a secondary diagnosis code? What are the requirements for coding and billing the Chronic Care Management codes for Medicare patients? These questions and more will be addressed by the instructor who will share her knowledge and guide you through the process of accurately coding for chronic conditions.