HCC Coding

2024 cms-hcc risk adjustment model

Upcoming Changes to 2024 CMS-HCC Risk Adjustment Model Include Reliable Predictors of Future Costs

By Vanessa Youmans / July 3, 2023 /

CMS updated the 2024 CMS-HCC risk adjustment model by including reliable predictors of future costs and excluding unreliable ones. In summary, the CY2024 CMS-HCC model classifies the ~74,000 ICD-10-CM diagnoses codes into 266 CMS-HCCs.

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CPT code consultants

Medical Coding Consultants Play Vital Role in HIM Industry, Especially During Times of Frequent Updates

By YES HIM Consulting / April 5, 2023 /

Times of frequent medical coding updates have highlighted the necessity of medical coding consultants, or coding subject matter experts (SMEs), to help healthcare providers navigate such changes.

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medical coding training

Medical Coding Training on Updates Ensures Accuracy & Compliance Standards

By YES HIM Consulting / November 2, 2022 /

Every year, the Centers for Medicare & Medicaid Services (CMS), and the American Medical Association (AMA) release updated coding and reporting guidelines that make additions, deletions, and revisions to the ICD-10 and HCPCS code sets, and CPT codes, respectively. During Public Health Emergencies (PHE), such as the COVID-19 pandemic, CMS and AMA will release updates more frequently. By offering ongoing medical coding training to cover these annual updates, your coding team upholds an accuracy standard and stays compliant with these revised guidelines. YES Education offers a robust catalog of medical coding updates that refreshes as the code set revisions are released, including annual updates for ICD-10-CM/PCS and CPT.

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HCC Coding 101

HCC Coding 101: How to Avoid Scrutiny As Risk Adjustment Schemes Come to Light

By Karen Youmans / June 20, 2022 /

Several recent lawsuits have brought to light a list of risk adjustment schemes to increase reimbursements in violation of the False Claims Act. Here are some HCC coding 101 best practices to help your organization avoid scrutiny.

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why is HCC coding important

Why Is HCC Coding Important? YES Case Study Highlights HCCs & Healthcare Technology

By YES HIM Consulting / May 25, 2022 /

What is HCC coding used for? Why is HCC coding important? This brief article will touch on the questions above and explore how a recent YES HCC consulting case study highlights the importance of HCC coding in healthcare.

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HCC coding audits

How an HCC Coding Audits Partner Can Help Your Facility

By Karen Youmans / May 16, 2022 /

Reducing your risk of inaccurate HCC coding and compliance issues begins with an efficient HCC auditing partner. An external HCC auditing consultant, like YES HIM Consulting, can conduct regular coding audits to identify issues before they are flagged.

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HCC medical

How HCC Medical Coding Can Turn Your Healthcare Organization Into a Profitable One

By Mari Cely / February 3, 2022 /

The cost of inaccurate HCC medical coding is detrimental to an organization’s bottom line. Without a true assessment of the patient’s care, the hospital’s reimbursement is lower, leaving money on the table.

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quick guide to hcc

Your Quick Guide to HCC Risk Adjustment Models

By YES HIM Consulting / November 18, 2020 /

There are two different Hierarchical Condition Category (HCC) models used to calculate risk adjustments: the CMS-HCC model and the HHS-HCC model. Does your facility know how and when to use them? Our detailed HCC risk adjustment infographic explains the differences and usages for each HCC model.

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medical coding companies

What Does It Mean for Medical Coding Companies to Have a 100% Client Retention Rate?

By YES HIM Consulting / October 20, 2020 /

Outsourcing no longer means time-zone hopping overseas to find reliable, skilled, and affordable medical coding and auditing companies dedicated to achieving high coding productivity and quality standards. It is increasingly common for healthcare organizations to outsource coding overflow and quarterly audits by sourcing talent from a U.S.-based company. YES HIM Consulting is proud to be a premier coding, auditing, and education preferred partner to large-scale healthcare systems, individual hospitals, physician groups, and more around the U.S.

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CMS advance notice

2022 Medicare Advantage Advance Notice Changes Process for Risk Adjustment Scores

By Karen Youmans / September 24, 2020 /

CMS has released Part 1 of the 2022 Medicare Advantage Advance Notice, which reviews the updates to the Part C CMS-HCC risk adjustment model and the application of encounter data (CMS, 2020). Changes to the CMS Advance Notice are scheduled to be finalized by April 5, 2021. HCC coding and risk adjustments are one of YES HIM Consulting’s many specialties. The Risk Adjustments & HCC Basics learning path from YES HIM Education provides an overview of the HHS and CMS risk adjustment models, documentation, coding practices, and much more.

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