# HCC Coding - Hierarchical Condition Category



## Love Coding!

Hi,

I was hired to do HCC coding for in-home health assessments.  What should I read up on to get more familiarized with this type of coding.  This will be for Medicare Advantage plans.  I have working knowledge of combination coding and chronics.  What would I need to know to code these type of visits out.  Any help would be appreciated.

Thank you!


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## Lynda Wetter

http://health-information.advancewe...g-CMSs-Hierarchical-Condition-Categories.aspx

Looks like this site might be helpful. I saw some links at the bottom. I have not fully explored this article, but I myself will be starting HCC coding in the next few weeks. I have never done it before but have spoken to many that have and said if you have an understanding og ICD-9 and understand what should be a prmary dx you should not have a problem coding these cases!!!


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## Love Coding!

*Thank you!*

Thanks so much Lulu79!  I will look into this today!


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## jsnyder

*Reply*

Yes, it is coding for reimbursement from Insurance companies for Risk Adjustment and additional money is paid to the provider for providing care for patients with multiple serious chronic diseases.  As above stated, you need to know what you are looking for but there is a lot more to it than just finding a code.  There are addendum time frames for the previous year, submits where the provider truly saw the patient for the codes that the company is wanting for the previous year (right now we are looking at 2012) , and the documentation that you capture has to be succinct, precise, and fit exactly with the code that you are submitting.   Maybe it is just the company I am working for that requires all the above, but I do get paid quite well for following their guidelines.

Regards:  tenaj


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## Lynda Wetter

Yes it's coding for reimbursement but not  the way most coders look at it.   For HCC  you don't code everything,  just chronic conditions  that have an hcc  value for  payment to Medicare advantage providers.  In regular coding you would code anemia  and  chest pain.   For HCC  you don't.   it's just different coding but very achievable,  like  coding for other note types  for example E/M  coding,  there are a ton of guidelines ( not to mention gray areas)  but if you have the basic concept of coding, especially combination codes  you will be fine.


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## elukem

*Condition Categories*

I can not seem to find anywhere online a list of all of the 2016 condition categories.  Does anyone have any resources? I have tried CMS, AMA, AHIMA and a dozen other google searches. 

I really just want a list of the HCC number and the title of the category

Thanks


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## camillecoder@hotmail.com

http://www.hccuniversity.com/


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## kfletcher01

*HCC Mappings*

Correct place to get the most current HCC Mappings is direct from the CMS website. See the link below:

https://www.cms.gov/medicare/health-plans/medicareadvtgspecratestats/risk-adjustors.html

Kristy Fletcher, CPC, CRC


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## davidmoreno83

*hiii*

what type of help do you need?you should use this app "Hcc pro helper"is a very useful app.


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## CULINTZ

https://www.cms.gov/files/document/updated-2022-benefit-year-final-hhs-risk-adjustment-model-coefficients-clean-version-508.pdf
		




			https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Final-2021-Benefit-Year-Final-HHS-Risk-Adjustment-Model-Coefficients.pdf


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