HCC Coding- 7 Things the Most successful Medical Group have common
                     
HCC Coding: 7 Things The Most 
Successful Medical Groups Have In 
Common 
  Understanding HCC coding has become critical for healthcare organizations to 
succeed in new payment models as we transition to value-based care. As a 
reminder, HCC coding enables providers and billing/coding teams to account for 
future health risks and costs at the patient level. Thereby, HCC accuracy impacts 
program success, especially for innovative programs such as Primary Care First.
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Following strategies to improve the HCC 
coding performance:
 Adhere to the M.E.A.T. Criteria
      Monitor:     signs, symptoms, disease progression, and disease regression.
      Evaluate:   test results, medication effectiveness, and treatment response
      Assess:       Ordering tests, discussion, reviewing records, and counseling
      Treatment: Medication, therapies, and other treatment options
 Provider Education
As HCC coding is a new concept far from intuitive, educating clinicians along the way is critical.           
       The most crucial educational point to emphasize to providers is the importance of accuracy, not 
the     score itself. The providers can be taught about the clinical and monetary value of specificity. 
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 Improve Decision Support with EMR Optimization
Although provider education is necessary to improve HCC coding accuracy, it is also critical to 
incorporate appropriate coding into the daily encounter workflow. Some potential strategies 
include ACO identifiers in the EMR, decision-support tools that can be activated for specific 
populations, and HCC diagnosis alerts for past codes.
 Preparation of an Accurate Problem List
To ensure an accurate problem list, remove duplicate and inactive diagnoses, identify critical 
areas with discrete data in the EMR, and prioritize results using a diagnosis preference list that 
includes HCC suffix codes and RAF values.
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 Tracking Performance
 Use Coding Experts
 Prepare for Each Patient Visit
 Best Strategy – Outsourcing Medical Billing & Coding!
Partnering with an experienced medical billing and coding company is the best way for 
physician practices to stay updated on changes in CMS’s risk adjustment model, ICD codes, 
HCC coding and crosswalks, and audit procedures. Click to know more..
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