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Risk adjustment coding

  1. #1
    Default Risk adjustment coding
    Medical Coding Books
    I would like to hear from people who do risk adjustment coding. I had never done risk adjustment until I started this new job. I work for a company that does risk adjustment and we are having a lot of trouble getting everyone on the same page. Of course, every ICD-9 code that is assigned has to be supported in the doctor's note. We are having a huge disagreement on what constitutes supporting documentation and often get conflicting information on what we can and can't use. It's very frustrating. For example, we have been told that a statement of "continue all meds" would support whatever diagnosis the doctor has given. However, many times the medications are not listed in the note. Today, we were told that this statement can not be used as support. I can give other examples but suffice it to say that I am extremely confused about what is acceptable supporting documentation and what is not. Is there any type of reference material (other than my coding guidelines) that I can use - textbooks, web sites, etc. that would be of assistance to me? I just want to learn to do this the right way!


  2. #2
    Albany Oregon
    Default HCC coding workshop
    Hi abill_423,

    I would like to suggest that you contact Ingenix and see if there are any presentations coming up for your area.

    Last year I attended a free workshop/seminar presented by Ingenix called "Diagnostic Coding for Medicare Advantage" that was very informative. It even included 4 CEUs. The speaker explained about the Risk Adjustment Factor and Methodology, the Hierarchical Condition Categories, just to name a few topics. There were coding question breaks along the way, where we had to use our ICD-9-CM books to code scenarios. It was well worth my time to attend.

    The Ingenix presenters also said that they would come to providers' offices to present coding classes geared for physicians and hospitalists on the Medicare Risk Adjustment with examples of chart documentation and model progress notes, free of charge. Ingenix is able to offer these coding classes for free, by partnering with the health plans who offer Medicare Advantage coverage. HCC coding is where "specificity" matters and pays off for the health plans at least!

    Maybe this would be beneficial to you and your office as well.

    Terri Powers
    aka truescaper

  3. #3
    Thank you so much! I will look into this and pass the information on to my bosses.

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