An Introduction to Hierarchical Condition Categories (HCC)
Is HCC coding hard?
If experienced medical office workers struggle with HCC coding, how hard will it be for someone with no experience? The difference is in the training. Although few can simply sit down and begin HCC coding, the training is very straightforward.
What does HCC mean in healthcare?
Risk Adjustment and Hierarchical Condition Category (HCC) coding is a payment model mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997.
What is an HCC risk score?
The CMS-HCC risk score for a beneficiary is the sum of the score or weight attributed to each of the demographic factors and HCCs within the model. The CMS-HCC model is normalized to 1.0. Beneficiaries would be considered relatively healthy, and therefore less costly, with a risk score less than 1.0.
Who uses HCC coding?
HCCs are used to calculate payments to healthcare organizations for patients who are insured by Medicare Advantage (MA) plans, Accountable Care Organizations (ACOs), some Affordable Care Act (ACA) plans and many more.
How can I improve my HCC coding?
Five Action Items to Improve HCC Coding Accuracy and Risk Adjustment With Analytics
- Having an accurate problem list.
- Ensuring patients are seen in each calendar year.
- Improving decision support and EMR optimization.
- Widespread education and communication.
- Tracking performance and identifying opportunities.
What is the highest paid medical coder?
The highest paying coding certification is Certified Professional Coder. As a Certified Professional Coder professional, you are likely to earn an average annual salary of $54,051.
Which coding certification is best?
What are the best certifications for today’s medical coders?
- Certified Professional Coder (CPC) credential from the AAPC.
- Certified Coding Specialist (CCS) credential from the AHIMA.
- Certified Coding Specialist – Physician-based (CCS-P).
How do I become a HCC coder?
HCC coders typically have an associate’s degree or certification in medical coding. Successfully completing a medical billing program can also help you find a job as an HCC coder. When on the job, you need to have strong data entry skills, with an emphasis on accuracy and speed. You also need organizational skills.
What is the HCC process?
The HCC process includes a prospective review of health status in a base year to predict costs in the following year. Assessments are also made of beneficiaries eligible for both Medicare and Medicaid (dual eligibility).
Is HCC curable?
Most people who develop HCC have cirrhosis, which is a build-up of scar tissue due to years of liver damage. Since HCC usually grows slowly in its early stages, it can often be cured if discovered early enough.
What is the full form of HCC?
Liver cancer begins in the cells of the liver. The most common form of liver cancer begins in cells called hepatocytes and is called hepatocellular carcinoma. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer.
How is HCC risk score calculated?
Sum of factors Demographic + Disease = Raw risk scores The relative factors for all of the demographic variables, HCCs, and interactions are added together. The result is the raw risk score.
How many HCC models are there?
There are two different models for Hierarchical Condition Category (HCC) risk adjustments. The U.S. Department of Health and Human Services (HHS) oversees the HHS-HCC risk adjustment model 2020, which covers commercial payers of all ages and determines risk payments for the current year.
What is HCC diagnosis?
Hepatocellular carcinoma (HCC) is a primary tumor of the liver that usually develops in the setting of chronic liver disease, particularly in patients with cirrhosis due to alcohol use, chronic hepatitis B or C virus infections, or nonalcohol-associated steatohepatitis (NASH) [1,2].