Online Training Course

Prod ID: 422
Importance of HCC Coding

Documentation and specificity are the keys to success with HCC coding. Improving accuracy of clinical documentation positively impacts Risk Adjustment Factor (RAF) scores and coding.

CEUs

1

Length

62 min

Price

$119.00


The collection and validation of patient diagnoses is organized first by diseases and conditions and then by condition categories. Documentation and specificity are the keys to success with HCC coding. For example, chart documentation must show that the condition was monitored, evaluated, assessed, or treated. A diagnosis code may only be reported if it is explicitly spelled out in the medical record.

Learning objectives include:

  • Optimize Hierarchical Condition Categories (HCC) and Risk Adjustment models
  • Identify the entities that use HCC and Risk Adjustment for population health and reimbursement.
  • Review best HCC Coding best practices
  • Develop an internal action plan to leverage HCC Coding

Kem Tolliver

CMPE, CPC, CMOM

Kem is the co-author of, “Revenue Cycle Management: Don’t Get Lost in the Financial Maze” published by MGMA®. She also created and delivered the first-ever Revenue Cycle Management Certificate program on behalf of MGMA. Medical practices managed by Kem have received MGMA® “Better Performing Practice” distinctions in the areas of Accounts Receivable and Collections. As a national and regional SME, Kem develops and delivers educational content to industry leadership.

Mrs. Tolliver holds dual Bachelor of Science degrees in Healthcare Administration and Organizational Management; Summa Cum Laude and Magna Cum Laude respectively. Her certifications include: Certified Medical Practice Executive (CMPE), Certified Professional Coder (CPC) and Certified Medical Office Manager (CMOM). For over 20 years she has provided strategic and operational leadership to medical practices and hospitals. As the President of Medical Revenue Cycle Specialists, LLC (MRCS) her team leads Health Care Organizations in: Practice Start Up and Transformation, Revenue Cycle Improvements, Clinical Documentation Improvement, Educational Programing, Payer Contracting, HIT Software Development, EMR/PM software customization and Telehealth integration.

Kem has served on the Board of Directors of MD MGMA as the Chair of the Practice Management Committee and Chair of the Government Affairs Committee. She received MD MGMA’s 2016 Outstanding Service Award and was the 2018 State of Maryland ACMPE Certification Rep.

This course will provide clarity on HCC coding situations and help you ensure that consistent, accurate, and complete documentation processes are in place.
No prerequisites required.

The collection and validation of patient diagnoses is organized first by diseases and conditions and then by condition categories. Hierarchical Condition Categories (HCC) play a vital role in demonstrating illness complexity, assessing the health of populations and payment for healthcare services. The importance of consistent, accurate, and complete documentation in the medical record can't be overemphasized. Documentation and specificity are the keys to success with HCC coding. A diagnosis code may only be reported if it is explicitly spelled out in the medical record.

Improving accuracy of clinical documentation positively impacts Risk Adjustment Factor (RAF) scores and coding. This program will help you ensure that consistent, accurate, and complete documentation processes are in place. Get clarity for HCC coding situations. For example, two sources of data determine a patient's RAF - demographics and health status based on ICD-10-CM codes.

Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.

Comments from past participants:

"It was a great presentation. All practices need this vital information."

"Excellent; good up to date information."

"It was very informative and educational. "

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