20160430 - Save up to 35% on Everything You Need to Get Certified | Learn More

Results 1 to 7 of 7

Thread: ICD-10 and HCC Coding for Risk Adjustment

  1. #1
    Join Date
    Apr 2007
    Location
    Urbana, IL
    Posts
    23

    Default ICD-10 and HCC Coding for Risk Adjustment

    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.

  2. #2

    Default

    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.
    Sherry Miller, MBA/HCM, CPC, CEMC
    Epic Management, LP

  3. #3
    Join Date
    Apr 2007
    Location
    Lakeland, FL
    Posts
    17

    Default 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.

  4. #4
    Join Date
    Apr 2007
    Location
    Urbana, IL
    Posts
    23

    Default

    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.
    Regards!
    Dawn Peterson
    Coding Consultant/Billing and Coding Instructor
    Illinois, USA

  5. #5
    Join Date
    Apr 2007
    Location
    Professional Coders of Central Pennsylvania (PCOCPA), Harrisburg, Pennsylvania
    Posts
    76

    Default

    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.
    Jennifer (Jenny) M. Oravecz, CPC
    Past Vice President/Education Officer (2012/2011) of Professional Coders of Central Pennsylvania (PCOCPA), Harrisburg, Pennsylvania
    Past President/President-Elect (2009/2008) of Professional Coders of Tidewater, Chesapeake, Virginia

  6. #6
    Join Date
    Apr 2007
    Location
    Charleston, South Carolina
    Posts
    636

    Default

    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!!
    Last edited by mmorningstarcpc; 04-26-2012 at 06:39 AM.
    Machelle Morningstar, CPC, CPC-H, CEMC, COSC

  7. #7

    Default Hcc & icd10

    Great Information - very much appreciated - Thank you

    Claudine
    Claudine Rosson, CPC, CPC-I
    Clinical Quality Analyst, SR
    Lifeprint Health

Similar Threads

  1. HCC/Risk Adjustment Coding
    By AB87 in forum Diagnosis Coding
    Replies: 2
    Last Post: 09-10-2013, 06:50 AM
  2. Risk Adjustment and HCC Coding
    By st1114718 in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 04-25-2011, 11:27 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.