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Another Year – Another HCC

Holly Cassano

CPC CRC ICD 10CM CERTIFIED
Staff member
HCC Moderator
Another Year – Another HCC

Every year, CMS turns the clock back to zero on HCCs. Diagnoses that were reported in the previous year and used for Risk Adjustment to determine acuity of members in a Medicare Advantage Plan are “dropped off” by CMS and the member is back to zero diagnosis codes in their Risk profile. CMS recommends reporting chronic conditions at minimum, once per year in order to effectively capture a members Health Risk Profile.
 

Alicia Scott

Moderator, CCO Instructor
Staff member
Administrator
Moderator
Blitzer
PBC Student (CPC®)
CCO Club Member
CCO Support Staff
MTA Student
ICD-10-CM Student
PPM Student (CPPM®)
FBC Student (CPC-H®)
This is important for all of us to remember. Do you know what version we are in now? I really like Find-A-Code because they do such a great job of telling us all the HCC's. Here is an example:
250.00 - Diabetes mellitus without mention of complication or manifestation;type II or unspecified type, not stated as uncontrolled
Short Descr: DMII wo cmp nt st uncntr
CMS-HCC v12: 19 - Diabetes without Complication
CMS-HCC v21: 19 - Diabetes without Complication
CMS-HCC v22: 19 - Diabetes without Complication
CMS-HCC ESRD: 19 - Diabetes without Complication
CMS-HCC Rx: 15 - Diabetes without Complication
HHS-HCC (ACA): 21 - Diabetes without Complication
 

Holly Cassano

CPC CRC ICD 10CM CERTIFIED
Staff member
HCC Moderator
Hi Alicia,

We are currently using the V22 model for 2015 forward, last year was a blend of two, V12/V21

This is important for all of us to remember. Do you know what version we are in now? I really like Find-A-Code because they do such a great job of telling us all the HCC's. Here is an example:
250.00 - Diabetes mellitus without mention of complication or manifestation;type II or unspecified type, not stated as uncontrolled
Short Descr: DMII wo cmp nt st uncntr
CMS-HCC v12: 19 - Diabetes without Complication
CMS-HCC v21: 19 - Diabetes without Complication
CMS-HCC v22: 19 - Diabetes without Complication
CMS-HCC ESRD: 19 - Diabetes without Complication
CMS-HCC Rx: 15 - Diabetes without Complication
HHS-HCC (ACA): 21 - Diabetes without Complication
 

Alicia Scott

Moderator, CCO Instructor
Staff member
Administrator
Moderator
Blitzer
PBC Student (CPC®)
CCO Club Member
CCO Support Staff
MTA Student
ICD-10-CM Student
PPM Student (CPPM®)
FBC Student (CPC-H®)
That is a good point to remind people Holly. I like how Find-A-Code lists them all. I think Find-A-Code is the only one that gives you the HCC's.
 
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