# ICD-10 and HCC Coding for Risk Adjustment



## dpeterson39 (Apr 9, 2012)

With all the changes from day to day, I am sure the topic is hush hush for a reason, but I thought I would take a stab at asking. Has anyone found materials supporting the changes to be expected with Hierarchical Condition Categories with regard to ICD-10? I have heard that DRGs have been tasked for investigation in approximately 2015 but I am wondering if anyone has found articles or proposals by CMS on their risk adjustment system for Medicare Advantage plans.


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## SherryMiller (Apr 9, 2012)

I haven't seen anything.  I wouldn't suppose that there will be much info for a while since the first recalculation using the ICD-10s won't happen until July 2015.


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## hinditina (Apr 9, 2012)

*National Conference*

I just got back from AAPC national conference and this very question was asked. The speaker had come to the same conclusion that nothing has been mentioned. I honestly don't think too much will happen. ICD-10 is about being very specific to the coding there won't be much in unspecific codes. I don't think there will be much of an impact. They just put out this afternoon that the push back for ICD-10 is now 2014. I think in 2014 that when we will know.


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## dpeterson39 (Apr 10, 2012)

Thank you for your insight, I am on the same page. I plan to do the mapping/cross walking of the current 3000+ I9s as they relate to the I10s in the 70 medical HCCs with the hopes that we will be able to use a mapping tool of sorts to do the bulk of the work. If anyone else has insight or if data is found please feel free to share, and I will do the same.


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## jmoravecz (Apr 23, 2012)

I attended a Risk Adjustment conference 2 weeks ago and asked the CMS presenter about this.  I was told that they are still in process with reviewing; that the mapping/crosswalking will require significant clinical, as well as significant coding, consideration.


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## mmorningstarcpc (Apr 24, 2012)

At the Coordination and Maintenance Meeting, it was said that since the DRGs were recently converted to MS-DRGs (a couple of years ago), that they would most likely wait two years (after implementation of I-10) and review the data before upgrading the MS-DRGs.  Remember too, that CMS is two years behind when reviewing data.

Hope this helps!!


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## claudine (Apr 25, 2012)

*Hcc & icd10*

Great Information - very much appreciated - Thank you

Claudine
Claudine Rosson, CPC, CPC-I
Clinical Quality Analyst, SR
Lifeprint Health


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## rhenderson@mcleodhealth.org (Feb 2, 2018)

*HCC/Risk Adjustment*

I am over the inpatient CDI program at our acute care facility and we are looking to expand into the physician practice. I am looking for any organization who has an outpatient CDI program in place, or a program which focuses on documentation review/HCC capture, risk adjustment. If anyone has a program (success stories or opportunities) they are willing to discuss, please contact me at the email below, I would from someone who as already been through an implementation.

 Thanks,
 Reeanna Henderson
rhenderson@mcleodhealth.org

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 Reeanna Henderson MBA-HM, BSN
 AVP Case Management/CDI
 McLeod Regional
rhenderson@mcleodhealth.org
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