Wiki HCC Question - please help me understand

[jenniepat]

Good morning! Could someone tell me why aortic aneurysm I71.9 be an HCC, but the more specific Thoracic aortic aneurysm I71.20 would not be an HCC?

 

[sls314]

Good morning! Could someone tell me why aortic aneurysm I71.9 be an HCC, but the more specific Thoracic aortic aneurysm I71.20 would not be an HCC?

I71.20 was a new code effective 10/1/2022.

There hasn't been an update mapping new codes to HCCs yet. You won't see any new codes on the HCC listing yet.

 

[tmmoreland2017]

GM, Medicare has both dx for 2022 as HCC 108 for both V22 and V24. Neither are a CC for ACA

 

[sls314]

I do agree that the new codes I71.20 - I71.23 will likely be added to HCC 108.

Prior to 10/1/22, the code was I71.2 and it was HCC 108. There's just a lag between when new codes are effective and when they are incorporated into the models.

 

[jenniepat]

I71.20 was a new code effective 10/1/2022.

There hasn't been an update mapping new codes to HCCs yet. You won't see any new codes on the HCC listing yet.

Oh great! Thank you so much!. How would I know that this code was effective 10/1/2022? Is there somewhere I can reference new codes added? We use the most recent mappings on the cms.gov website

 

[sls314]

Oh great! Thank you so much!. How would I know that this code was effective 10/1/2022? Is there somewhere I can reference new codes added? We use the most recent mappings on the cms.gov website

Do you use a ICD-10-CM book or an encoder? Any of those should have a symbol or way to flag the new and/or revised codes.

My 2023 book uses circle and triangle symbols to show new codes.

My encoder (EncoderPro) flags it as a "New Code" in the column to the right.

Also if you scroll down to the Code History field, EncoderPro shows:
Change Effective Date: 10/01/2022
Change Summary: Officially recognized, Other, New

Different encoder products may have different ways of displaying it - if you look up I71.20 in whatever encoder you use, you should be able to see how that encoder flags new codes.

 

[jenniepat]

Do you use a ICD-10-CM book or an encoder? Any of those should have a symbol or way to flag the new and/or revised codes.

My 2023 book uses circle and triangle symbols to show new codes.

My encoder (EncoderPro) flags it as a "New Code" in the column to the right.

Also if you scroll down to the Code History field, EncoderPro shows:
Change Effective Date: 10/01/2022
Change Summary: Officially recognized, Other, New

Different encoder products may have different ways of displaying it - if you look up I71.20 in whatever encoder you use, you should be able to see how that encoder flags new codes.

Fantastic!! Thank you so much for your guidance. I use encoder for our icd10 codes. I'm assuming they will continually add HCC codes every 6 months since the mappings are updated every 6 months.