# Are you a CRC and/or do HCC risk adjustment coding? If so I would like your feedback!



## jraykovicz (Apr 6, 2016)

Hi there,
I very much would like to prepare for my CRC certification. My primary purpose is for the potential to work remotely as well as be able to independently consult on risk adjustment coding for healthcare systems and health plans alike, particularly on HCCs.  However, I want to make sure I know what I am getting into as far as expectations of a risk adjustment coder. My questions are:

- Is it common for Risk Adjustment Coders/CRCs  to also have a clinical background or active clinical license, such as RN, FNP? I have seen several management-level risk adjustment coding jobs with these requirements. (thinking career advancement potential, since I do not, and will never, have any type of clinical credential)

- Are Risk Adjustment Coders also expected to code ICD-10 PCS as well as inpatient?  Or does this depend on the job itself? My background is primarily physician office/professional billing/coding/reimbursement, so I do not feel I could easily transition to any PCS/inpatient charts.  Does this limit my options?

Thank you for your time and feedback! I think risk adjustment coding is a tremendous opportunity to get a leg up on due to the Affordable Care Act, Medicare Advantage plans, etc, but it's a huge time and $ investment (cost of prep course, exam, etc) so I wanted to be sure I did my homework first. 

Would love to know your thoughts!

Regards,
Jill


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## debi7478 (Apr 7, 2016)

I am a CRC and LVN and CPC.  I find that if you are at least a seasoned CPC learning HCC is not too difficult but not having any coding background and trying to do HCC is not an easy feat.   Of Course being clinical or having clinical experience will definitely help.   Knowledge of Anatomy and Pathophysiology along with medical terminology is a MUST for HCC and even coding if you think about it.  ICD-10 is extremely anatomy driven.   As far as PCS that is coding for Inpatient services CM is just the professional component of coding.  I have been a nurse my entire career and could not do inpatient coding even today.   Are you going to the conference this next week?  

Debi7478@aol.com



jraykovicz said:


> Hi there,
> I very much would like to prepare for my CRC certification. My primary purpose is for the potential to work remotely as well as be able to independently consult on risk adjustment coding for healthcare systems and health plans alike, particularly on HCCs.  However, I want to make sure I know what I am getting into as far as expectations of a risk adjustment coder. My questions are:
> 
> - Is it common for Risk Adjustment Coders/CRCs  to also have a clinical background or active clinical license, such as RN, FNP? I have seen several management-level risk adjustment coding jobs with these requirements. (thinking career advancement potential, since I do not, and will never, have any type of clinical credential)
> ...


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## jraykovicz (Apr 13, 2016)

Hi Debi,
Thanks so much for your reply. I am not at Healthcon, but would love to get more info from you on the CRC/risk adjustment field.  

If you are at the conference, do you mind sending me a quick email when you get back when you are available to chat?

My email is jill@physician-practice-consultants.com

Thanks!
Jill


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## rdpagayucan (Apr 14, 2016)

*HCC coding*

Hi,

Clinical background is a big help in any part of coding OP,IP. Home health, and HCC for that matter. But, there's a lot of non-clinical people I know that invest time in learning Anatomy and Physiology. 

Usually before you can be a remote coder you should have at least good experience in coding for such specialty and in this case HCC/ Risk adjustment coding.

HCC coding only deals with diagnosis coding that maps to CMS-HCCs RxHcc and or other HCC models being used. But there are talks that in the future it go to coding procedures.  

Godbless!!!


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