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HCC coding - ICD-9 coding

  1. #1
    Default HCC coding - ICD-9 coding
    Medical Coding Books
    I need feedback on HCC coding. Is it easier than straight ICD-9 coding? Is HCC coding more time consuming than straight ICD-9 coding? Is there somewhere I could get a list of the HCC codes?


  2. #2
    Hi Tammy, From what I understand, HCC coding is about being as specific as possible when choosing ICD-9 codes (as we should be anyway but sometimes charges aren't reviewed before going out) because the HCC ranking assigned to the codes is a severity ranking. That also means the providers have to be as specific as they can about the diagnoses they see the patient for. CMS has information on their website (CMS Home>Medicare>Medicare Advantage -Rates & Statistics>Risk Adjustment) and there are some videos and other information on www.hccblog.com.
    Pam, CPC, CPC-P

  3. Default

    HCC coding you are only capturing the most severe dx's. There are only only 3,000 some icd-9 codes that have an hcc for them. You code it, look up the hcc that matches the code. If you don't see the code in the hcc manual, then the dx does not fall under an hcc, therefore you don't code it. This is for regular hcc coding. (Now they have RX hcc's which is different.)

  4. #4
    I would still code applicable codes even if they didn't have an HCC value so it tells the complete story of why the patient was in. You definitely need to make sure that you do code ones that have an HCC value. Providers need to be educated to document all problems that come into play with a particular visit so those HCC codes can be used.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    National Advisory Board Member 2018-2021, Region 6 Great Lakes

  5. #5
    Rochester NY
    my job is working with HCC's. It is about coding as specific as possible.

    HCC's ( Hiererchial condition categories) were designed to assign scores to health carriers members' based on their degree of sickness.
    I'm not sure if I can get into the specifics of it - the nitty gritty - but know that CMS using the HCC model makes for a more accurate prediction of health care/medical costs.

    One should always code to the highest level of specificty anyway, and always code on the claim all the conditions a patient was treated for in an encounter. If a patient comes in for a sore knee but they also review the blood sugars with the PCP because they have diabetes, it is very appropriate to code for BOTH the knee issue and the DM - provided, that is, that it is documented in the chart.

    Remember the golden rule : if it's not documented, it didn't happen!!!
    A. Judd

    2013 President, Flower City Professional Coders
    2012 Vice President, Flower City Coders local Chapter
    2011 Member Development Officer, local chapter

    "You cannot truly listen to anyone and do anything else at the same time." M. Scott Peck

  6. #6
    Is there a book or website other than the hccblog that I can use as reference? I just got a job and I am to be doing hcc coding.
    I appreciate all your help!

  7. #7
    Default Hcc
    CMS website. HCC is a CMS program

  8. #8
    San Gabriel Valley,CA
    Default HCC Coding
    I have used the following websites to research on HCC coding. I just finished a couple of projects dealing with HCC coding. I did audits for various Doctors and found some useful tools on these sites.
    Hope you find them helpful as well....
    Elizabeth M., CCS, CPC, ICD-10 CM/PCS
    Multi Specialty Coder/Compliance Auditor/ICD-10 Educator

  9. #9
    San Gabriel Valley,CA
    Default HCC Coding
    Elizabeth M., CCS, CPC, ICD-10 CM/PCS
    Multi Specialty Coder/Compliance Auditor/ICD-10 Educator

  10. Question HCC coding
    Would you please explain me what is exactly HCC coding.And the difference between part I and part II.

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