Hierarchical Condition Category (HCC)

Hierarchical Condition Category (HCC) Coding

Course Description

Risk Adjustment and Hierarchical Condition Category (HCC) coding is a payment model implemented by the Centers for Medicare and Medicaid Services (CMS). This model assigns a risk factor score to patients with chronic illnesses based on the patient’s diagnosis and demographics. In this class students will learn how to audit for appropriate HCC code assignment utilizing the ICD-10-CM coding system. Specific payer risk adjustment guidelines will be reviewed as well as correct code assignment based on the American Hospital Association Coding Clinic rules and regulations for ICD-10-CM. Upon completion of this class students will be able to sit for the National HCC certification exam. Students should be certified in coding or have experience with the ICD-10-CM medical coding system.