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HCC codes

S

Sheri Lynn

Member
CCO Club Member
CCO Practicoder
Alecia, this is mainly for you, but anyone else that knows, please share :) My question was what is the difference between HCC and RXHCC? I am doing data entering, and both are listed in my program. Also, is there somewhere I can go to get a list of the mappable codes and their HCC numbers? Any help would be appreciated. Thanks, Sharon
 
A

Alicia Scott

Moderator, CCO Instructor
Staff member
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Blitzer
PBC Student (CPC®)
CCO Club Member
CCO Support Staff
MTA Student
ICD-10-CM Student
PPM Student (CPPM®)
FBC Student (CPC-H®)
The difference in HCC and RxHCC is best explained with an example.
152.0 CA of the duodenum carries an HCC of 9 and the RxHCC is 11
272.4 Hyperlipidemia carries only an RxHCC-23
There is also a PACE category.

The HCC is a chronic condition where as the RxHCC is the medication expense for a chronic condition.
So, you don't get to collect 272.4 unless you are pulling for the RxHCC. At times you will pull for only the HCC and other times you will be asked to get both.
We offer this information in our extra tools for the HCC course. Here is a link:
https://docs.google.com/a/cco.us/spreadsheets/d/115d7CR3V-yNc-iZ9xAaACDkBcFT5b1ZTe6d444msngI/edit#gid=790028522
 
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