Back to School: HCC Coding 101 for Beginners

Back to School: HCC Coding 101 for Beginners

As fall hits and kids across the country go back to school, whether it be virtually or physically in the classroom, it’s important to remember that we’re never too old to keep learning. That is why HCC Coders is bringing you back to school with HCC Coding 101 for Beginners!

What is HCC coding?

HCC Coding stands for Hierarchical Condition Category Coding. This method of coding was put in place by Medicare in 2004 as a means to adjust capitation payments for private healthcare plans. These codes are typically based on health expenditure risk profiles. These profiles are derived for Medicare Advantage Plan members.

Why is HCC coding important?

There are many reasons why HCC coding is important. Currently, with the CMS model, HCC risk scores play into benchmark calculations for MSSP ACO’s. These risk scores also affect capitation rates for Medicare Advantage plans. When considering exchange-based insurance products, the risk scores are also important because CMS prefers a modified version for those looking to purchase plans from the federal health insurance exchange. All of these reasons make it extremely important to have accurate and updated HCC’s.

Are there challenges associated with HCC coding?

While it can be slightly confusing trying to decipher HCC codes, there are additional challenges associate with it. Some plans use different methodologies to capture HCC codes from their providers, which can make the process of sorting through and analyzing data much more difficult because it isn’t always accurate. Without accurate and thorough data and documentation, gaps can form in the coding, which detracts from the process.

Who can offer assistance with HCC coding?

If you are looking for assistance with your HCC coding tasks, you need to call the experts at HCC Coders. We have been connecting certified coders with health plan providers since 1993 and would be happy to offer assistance with your HCC coding tasks as well.

Contact HCC Coders today for help with your HCC coding!

If you are looking for assistance with HCC coding, HCC Coders is the company to turn to. With over 28 years of experience, you can trust our qualified coders to get the job done. We hire only the best certified coders and they can work separately or in conjunction with your in-house coders. We know how critical it is to perform coding as accurately as possible and look forward to working with you. Give us a call at 877-328-2343 to get started!

To learn more about the reliable and quality HCC coding services that we offer, visit us on the web at HCC Coders.