Medical practices are assessing the impact of the change in the HCC model from V24 to V28, a phased in change that begins in 2024. CMS pays … [Read more...]
Diagnosis coding
Diagnosis coding establishes the medical necessity for a service, and can be the source of denials. Accurate and specific diagnosis coding is also important for groups that are part of ACO or have risk-contracts in communicating the acuity of a panel of patients.
What are Social Determinants of Health?
Question: Can you settle this question for our coding team? Are smoking and drinking considered Social Determinants of … [Read more...]
Coding Clinic Update, 2Q, 2023
Dr. Kennedy has generously allowed me to share his summary. He emphasizes that he is paraphrasing the recent advice in the spirit of “fair use” and we … [Read more...]
HCC Transition from V24 to V28 | Webinar
HCC Transition from V24 to V28 Recorded July 20, 2023 CMS is transitioning risk coding from the 2020 V24 model to V28 beginning in 2024. … [Read more...]
Compliance Issues in ICD-10 Coding for Risk Based Contracts and HCCs
Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here's an important excerpt. "Code all documented … [Read more...]
ICD-10-CM: 2023 Coding and Reporting Guidelines | Webinar
ICD-10-CM: 2023 Coding and Reporting Guidelines Recorded October 20, 2022 with special guest Margaret Skurka, MS, RHIA, CCS, FAHIMA Every year, … [Read more...]
Diagnosis Coding for Antepartum Care
Question: Patient seen for antepartum care but delivered at 38 weeks at a different hospital/physician group. What diagnosis codes should we … [Read more...]
Update to ICD-10-CM in 2022 including COVID and SDoH | Webinar
Recorded November 18, 2021 While there are only 159 new diagnosis codes in the ICD-10-CM code set, effective October 1, 2021, there are updates to … [Read more...]
HCC Diagnosis Coding Example: Diabetes, Hypertension, Chronic Kidney Disease
If a picture is worth 1000 words, what’s an example worth? An example can show in a glance what it takes paragraphs to write and explain. The one … [Read more...]
HCC Coding for Medical Practices | Webinar
HCC Coding for Medical Practices Recorded April 15, 2021 The rules related to HCC coding in physician practices are found in the ICD-10 book … [Read more...]
Diagnosis Coding for Biopsy Sent for Pathology
Question: What diagnosis code should you use when sending a skin biopsy to pathology? a) D48.5 Neoplasm of uncertain behavior of skin, or b) … [Read more...]
Coding for Hypertension in the HCC System | Reference Sheet
The code for hypertension was the first ICD-10-CM code I memorized, the year we all switched gears and learned the new system. This table lists the … [Read more...]
Coding for Diabetes in the HCC System | Reference Sheet
For medical practices who are part of an ACO, MSSP, or other Alternative Payment Model, understanding how to code accurately is critical to reporting … [Read more...]
Five Urban Legends About Risk-Adjusted Diagnosis Coding
Originally published on kevinmd.com When I talk to medical practices about Hierarchical Condition Category (HCCs) and risk-adjusted diagnosis … [Read more...]
Diagnosis Coding for Screening Colonoscopy
Some of you have read my article on coding for screening colonoscopy. The questions I get about that article are all related to diagnosis coding. The … [Read more...]
HCC’s in Brief | The Difference Between CMS-HCC and HHS-HCC
Demographics and diagnoses Risk adjusted diagnosis coding is a model used to predict future health care costs based on demographics and diagnoses. It … [Read more...]
ICD-10 Coding for Suspected Cancer
Diagnosis coding for possible malignancy How would you feel if your primary care physician and your general surgeon told you-and told your insurance … [Read more...]
Diabetes Coding in Hierarchical Condition Coding (HCC)
Diabetes is a common chronic condition, included in three distinct HCC categories Patients often have more than one chronic condition of the … [Read more...]
Depression Coding and Hierarchical Condition Coding (HCC)
Introduction | Depression coding in HCC In fee-for-service medicine: Diagnosis coding establishes the medical necessity for a service. At times, … [Read more...]
HCC Coding: Round Up of Chronic Conditions
I saw on twitter recently that COPD was the third leading cause of death in the U.S. If it was on twitter, it must be true, right? This article … [Read more...]
Can you Screen for an Existing Condition? | Diagnosis Coding for Lab Services
Sometimes, the hardest thing about coding for preventive services isn't the visit at all. It's the labs. Patients come in for an annual physical and … [Read more...]