HCC Coding from ECHO reports

emcee101

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I work for a large insurance company, and we are having a problem with one of our vendors coding HCCs from ECHO reports. Since there are not face-to-face provider visits, we all feel that there is no way that they qualify for risk adjustment under CMS guidelines. Can anyone provide concrete proof of this, relating specifically to diagnostic studies, from CMS or from another health plan perhaps? I would love something to give to them that can show without question that this does not meet RA guidelines.They have been fighting us about if for quite some time and we need to put an end to it. Thanks for any help.
 
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