ICD-10 and HCC Coding for Risk Adjustment

dpeterson39

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With all the changes from day to day, I am sure the topic is hush hush for a reason, but I thought I would take a stab at asking. Has anyone found materials supporting the changes to be expected with Hierarchical Condition Categories with regard to ICD-10? I have heard that DRGs have been tasked for investigation in approximately 2015 but I am wondering if anyone has found articles or proposals by CMS on their risk adjustment system for Medicare Advantage plans.
 

SherryMiller

Networker
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I haven't seen anything. I wouldn't suppose that there will be much info for a while since the first recalculation using the ICD-10s won't happen until July 2015.
 

hinditina

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Lakeland, FL
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National Conference

I just got back from AAPC national conference and this very question was asked. The speaker had come to the same conclusion that nothing has been mentioned. I honestly don't think too much will happen. ICD-10 is about being very specific to the coding there won't be much in unspecific codes. I don't think there will be much of an impact. They just put out this afternoon that the push back for ICD-10 is now 2014. I think in 2014 that when we will know.
 

dpeterson39

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Auburn, ME
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Thank you for your insight, I am on the same page. I plan to do the mapping/cross walking of the current 3000+ I9s as they relate to the I10s in the 70 medical HCCs with the hopes that we will be able to use a mapping tool of sorts to do the bulk of the work. If anyone else has insight or if data is found please feel free to share, and I will do the same.
 

jmoravecz

Networker
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BOILING SPRINGS, PA
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I attended a Risk Adjustment conference 2 weeks ago and asked the CMS presenter about this. I was told that they are still in process with reviewing; that the mapping/crosswalking will require significant clinical, as well as significant coding, consideration.
 

mmorningstarcpc

True Blue
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Charleston, South Carolina
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At the Coordination and Maintenance Meeting, it was said that since the DRGs were recently converted to MS-DRGs (a couple of years ago), that they would most likely wait two years (after implementation of I-10) and review the data before upgrading the MS-DRGs. Remember too, that CMS is two years behind when reviewing data.

Hope this helps!!
 
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claudine

New
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Phoenix
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Hcc & icd10

Great Information - very much appreciated - Thank you

Claudine
Claudine Rosson, CPC, CPC-I
Clinical Quality Analyst, SR
Lifeprint Health
 
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3
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HCC/Risk Adjustment

I am over the inpatient CDI program at our acute care facility and we are looking to expand into the physician practice. I am looking for any organization who has an outpatient CDI program in place, or a program which focuses on documentation review/HCC capture, risk adjustment. If anyone has a program (success stories or opportunities) they are willing to discuss, please contact me at the email below, I would from someone who as already been through an implementation.

Thanks,
Reeanna Henderson
rhenderson@mcleodhealth.org

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Reeanna Henderson MBA-HM, BSN
AVP Case Management/CDI
McLeod Regional
rhenderson@mcleodhealth.org
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