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Thread: HCC coding

  1. #41

    Default Hcc

    AAPC: Back to School
    I would like to learn about HCC, anyone having info? thanks

  2. #42
    Join Date
    Apr 2007
    Kachina East Valley Coders

    Default Answers for you

    Quote Originally Posted by sammie06 View Post
    To anyone who does HCC auditing:
    What is the criteria you look for when billing for COPD? Do you require additional test or do you just go with the physicians documentation?

    Also what requirement do you require for Hypoxemia? Do you require additional test or do you just go with the physicians documentation?

    Thanks for your help.
    Hi I have been doing HCC coding for 2yrs. To code COPD you simply would make sure the pt was truely assessed for COPD such as its listed in HPI, ROS, exam. You should also look for a med to tie it to COPD most providers use ADVAIR, and most importantly if the provider dx in final assessment w/a plan going forward. For HYPOXEMIA you need all the above and documentation that the pt is on O2 the final assessment dx and O2 status is what I look for with hypoxemia. Hopes this help..

  3. #43


    Hi, I'm currently working on a radv audit and some of the coders preferred to valided some of the hcc from a hospital discharge summary versus the pcp progress notes...the pcp is does states patient hcc conditions on the assestment...any thoughts

  4. #44
    Join Date
    Apr 2007
    Grand Canyon Coders


    Hi Patty,

    You can use them from a discharge summary as long as it meets all the other requirements (name, signature etc). Let me know if you need anything else.


  5. #45
    Join Date
    Apr 2007

    Question HCC Education

    I have been coding for 20+ years and specifically Medicare Risk Adjustment/HCC's for about 3 years now, and I was wondering if anyone has heard of any training, or certifications that might be coming up? Any other education, training sites that might be helpful? I am comfortable and confident in my work, I just haven't seen anything out there for further education. The CMS website is a nightmare, and HCC University is pretty good. Any other information would be helpful! Thanks

  6. #46

    Default hcc coding

    I love HCC coding.. It is very interesting to see the whole medical story in someone... Any hcc positions available that anyone knows of?

  7. #47


    HCC coding is different than straight ICD-9 coding. If you are coding for HCC capture, you look for only the codes of chronic conditions and they must be on the HCC list with an HCC value assigned...otherwise you don't code it, unless specifically instructed to code ALL diagnoses.y

    HCC are mainly used by Medicare Advantage carriers...they get higher reimbursement for patients with more chronic conditions, because they are sicker than someone with only one or no chronic conditions.

    I personally LOVE coding HCC!

  8. #48


    Me, too, Jess! I would also like to know of any HCC job openings! (My contract ended a few weeks ago...)

  9. #49


    I would appreciate information on extra training for HCC also!

  10. #50

    Question HCC codes

    Has anyone used the Helper HCC 2.0 app for your phone.. if knowing the rules under the WWW.CMS.HHS. COM site will it help to have the app?

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