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1. #Meat abbreviation in hcc coding how to#
2. #Meat abbreviation in hcc coding full#
3. #Meat abbreviation in hcc coding code#

HCC coding is a process used by healthcare providers to document and report diagnoses in a way that is compliant with government regulations. Say goodbye to uncertainty and hello to clarity with our innovative approach.

#Meat abbreviation in hcc coding how to#

Table of Content:Ģ- Common HCC coding challenges & potential solutionsģ- What is the MEAT-enabled HCC coding solution?Ĥ- How to implement a MEAT-enabled HCC coding solution in RA In this blog post, we will talk about how a MEAT-enabled solution simplifies HCC coding, streamlines the documentation process, and ensures accurate reimbursement. Have you been struggling to accurately capture patient diagnoses and risk scores? The ability to document with greater precision can dramatically impact payment amounts.Are you tired of the complexity and confusion that comes with hierarchical condition category (HCC) coding?

#Meat abbreviation in hcc coding code#

For example, diabetes with no complications, HCC code 19, pays a $894.40 premium bonus, while diabetes with ESRD, requires 2 HCC codes, 18 and 136, and has a bonus of $1273.60.

#Meat abbreviation in hcc coding full#

Specificity is essential to receive full reimbursement. Organizations who do not document the severity of their patient population to the highest specificity will not receive the appropriate reimbursement amount for applicable patients. Patients with high HCCs are expected to require intensive medical treatment, and clinicians that enroll these high-risk patients are reimbursed at higher rates than those with enrollees who have low HCCs. HCCs directly impact the amount of money received by healthcare organizations from the largest single payer in healthcare, CMS. Scores are calculated on an annual basis. Healthier patients will have a below average RAF while sicker patients will have a higher one, which impacts the calculated payment amount.

The PMPM is the payment amount a provider receives for a patient enrolled in an MA plan regardless of services provided. The resulting score is then multiplied by a predetermined dollar amount to set the per-member-per-month (PMPM) capitated reimbursement for the next period of coverage. Each HCC associated with a patient is assigned a relative factor that is averaged with any other HCC code factors and a demographic score. The RAF score is then used to calculate payments to healthcare organizations. What is a RAF score and what does it have to do with HCCs?Ī Risk Adjustment Factor, known as a RAF score, is a measure of the estimated cost of an individual’s care based on their disease burden and demographic information. The top HCC categories include major depressive and bipolar disorders, asthma and pulmonary disease, diabetes, specified heart arrhythmias, congestive heart failure, breast and prostate cancer, and rheumatoid arthritis. The reclassification also changed the number of ICD-10-CM codes represented from 9,700 to 7,770 within the various HCCs. The number of HCC categories expanded from 86 to 115 when CMS clinically reclassified the model. HCC codes represent costly chronic health conditions, as well as some severe acute conditions. What kinds of conditions do HCCs represent?