HHS and Medicare HCCs: Coding and Auditing at its Best

Event Information
Product Format
Prerecorded Event
Victoria M. Hernandez, RHIA, CDIP, CCS, CCS-P, AHIMA-Approved ICD-10-CM/PCS Trainer Founder, Integrity Coding Solution
60 minutes
Product Description

Enhance your knowledge on how to accurately and appropriately capture HCCs in coding, CDI and auditing

For over a decade now, the CMS hierarchical condition categories (CMS-HCC) model was implemented for the intended use of paying plans appropriately for the predicted health cost expenditures of their enrollees. As part of the Affordable Care Act, HHS-HCCs Risk Adjustment Model was created for individual and small group markets inside and outside exchanges. In this presentation, expert speaker Victoria M. Hernandez will cover the background of HCCs and enhance knowledge on how to accurately and appropriately capture HCCs in coding, CDI and auditing.

With the IPPS Final Rule in place effective October 1, 2016, a large volume of revised codes require accurate, concise and compliant code assignment, quality documentation and CDI reviews surrounding HCCs. Victoria will cover the many roles in revenue cycle involving HCCs, from CDI reviews, to coding, to analyzing quality data, to querying and auditing.

Session Highlights:

  • Understand definition of Risk Adjustment
  • Review background of Hierarchical Condition Category (HCCs)
  • Understand key components of coding and auditing HCCs
  • Case examples on coding HCCs
  • Enhancing knowledge and list comparison between CMS-HCCs and HHS-HCCs models
  • Review coding updates on IPPS Final Rule impacting HCCs
  • Identify best practices in a compliant query process for HCCs

Session Snapshots:

  • Goals and Objectives
  • Background - Risk Adjustment
  • What are HCCs - Overview and model types
  • CMS HCCs - Model
  • Medicare Enrollment Statistics
  • HHS-HCCs - Model
  • CMS and HHS HCC Comparison - Similarities and differences
  • Documentation
  • Risk adjustment data validation audits
  • Inpatient Prospective Payment System Updates (IPPS) summary
  • ICD-10-CM official guidelines for coding and reporting FY 2017
  • UHDDS and coding updates
  • AHIMA practice brief
  • Compliant coding
  • Auditing

Who Should Attend?

  • Hospital and Clinic Coding Staff
  • Coding Compliance and Privacy Staff
  • Managers
  • Directors
  • Auditors
  • CDI Staff
  • Clinicians

Order Below or Call 1-866-458-2965 Today

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About Our Speaker

Victoria M. Hernandez - AHIMA-Approved Trainer

Victoria M. Hernandez is an RHIA (Registered Health Information Administrator), a Clinical Documentation Improvement Practitioner (CDIP), Certified Coding Specialist (CCS), Certified Coding Specialist Physìcian-Based (CCS-P), an AHIMA-Approved ICD-10-CM/PCS Trainer and AHIMA CDIP Exam Item Writer with over 21 years of experience in the healthcare field. She is the founder of an auditing, coding and CDI company called Integrity Coding Solutions. Prior to starting her company, she was the...   More Info
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