More About the Course

The course does not simply present HCC coding rules but goes much further.

HCC (Hierarchical Condition Categories) Coder/Auditor Course – ICD‐10-CM

Accurate coding of thorough documentation is essential to help ensure appropriate reimbursement for delivered services. Risk Adjustment and Hierarchical Condition Category (HCC) coding, a payment model mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997, is no exception. HCCs are used pervasively in value based reimbursement including risk adjusted methodologies such as Medicare Advantage, ACOs and the Affordable Care Act.

Since the majority of HCCs are assigned by physicians or their office staff who frequently have less formal training, supporting documentation and coding compliance must be audited. Similar to inpatient DRGs, HCC specialists must be able to read an entire chart and be able to develop unique queries to physicians in reference to their documentation. This course provides the unique training necessary to be successful in this role.

The five section course is broken into modules, which create natural places within the course to pause and return later. The learner must score at least 80% on each sectioned quiz before moving forward to the next section.

HCC Course ICD‐10: Course Overview

•    Reference Materials, Worksheets and Study Guides
•    Section 1 – What is HCC
•    Section 2 – Documentation and Auditing Guidelines for HCC
•    Section 3 ‐ Coding Guidelines and Conditions by Chapter
•    Section 4 ‐ General Guidelines – Chart Notes – HCC Coding
•    Section 5 – Suspects and the Query Process
•    Final Exam