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HCC Coding
- Thread starter Alicia Scott
- Start date
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®)
HCC coding is all about lines. You have to be able to draw a line between the dx and support. If you can't draw the line you can't code it.
For example: Patient has in the Assessment DM2 then you would check to see what medication the pt. is on. If they take insulin you would be able to code 250.00 and V58.67. On the other hand if the patient came in for a sore throat and also has DM2 you may not be able to code the DM2. During the entire encounter if the DM2 is only mentioned in the PFSH and no med list is given or a there is nothing to indicate that the pt. has DM2, even if you know they do you can't code it because there is no support. You can't draw a line. A sore throat does not have an HCC so it can't be coded.
That is just a brief overview of how it is done. The H in HCC stands for Hierarchy. What you are coding for is dx that have a life altering effect for the patient. Thus DM has an HCC but Strep Throat does not. Osteoporosis had an HCC but Osteopenia does not.
There is a lot to learn and it entails a lot of reading. You have to pick apart the medical record each encounter at a time. Being comfortable with reports is very important. It is said that you don't memorize codes and you are not supposed to do that but it is true that if you use them over and over again you will find yourself knowing some by heart. Since HCC coding is all Dx coding you only use ICD-9 codes. No E codes but you do use V codes, like V49.76 and V85.41
It can be a lot of fun. I enjoy it but I really like ICD-9 coding. Plus I enjoy reading reports. In my opinion if you like HCC coding you would like auditing or vise versa.
For example: Patient has in the Assessment DM2 then you would check to see what medication the pt. is on. If they take insulin you would be able to code 250.00 and V58.67. On the other hand if the patient came in for a sore throat and also has DM2 you may not be able to code the DM2. During the entire encounter if the DM2 is only mentioned in the PFSH and no med list is given or a there is nothing to indicate that the pt. has DM2, even if you know they do you can't code it because there is no support. You can't draw a line. A sore throat does not have an HCC so it can't be coded.
That is just a brief overview of how it is done. The H in HCC stands for Hierarchy. What you are coding for is dx that have a life altering effect for the patient. Thus DM has an HCC but Strep Throat does not. Osteoporosis had an HCC but Osteopenia does not.
There is a lot to learn and it entails a lot of reading. You have to pick apart the medical record each encounter at a time. Being comfortable with reports is very important. It is said that you don't memorize codes and you are not supposed to do that but it is true that if you use them over and over again you will find yourself knowing some by heart. Since HCC coding is all Dx coding you only use ICD-9 codes. No E codes but you do use V codes, like V49.76 and V85.41
It can be a lot of fun. I enjoy it but I really like ICD-9 coding. Plus I enjoy reading reports. In my opinion if you like HCC coding you would like auditing or vise versa.
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®)
It is fun but let me warn you the training is intense. Worth it in my opinion but you want to connect with a group that has good training. Some of the coders I work with have done HCC coding before and they said the training they received was not very good.
You are correct there are all kinds of things you can do as a coder. Find your niche and work on it.
You are correct there are all kinds of things you can do as a coder. Find your niche and work on it.
This was my first coding position--doing HCC Coding and I loved it
! I would love to go back to this as a remote coder.
! I would love to go back to this as a remote coder.
Becky Curtis
Member
Thanks to all of you for the great information. I am a newly credentialed CPC-A and in the process of finding my first job coding or in a medical facility. I have seen job listings that were for HCC coding and initially had no idea what it was for, but have since spent time researching this type of coding. I love reading charts and like the diagnosis coding, but first I need to get my foot in the door somehwhere. For the time being I am trying to be a sponge and learn as much as I can about this career.
Becky, I just started a new job doing HCC Coding and I am working at home which means I am a remote medicall coder. I am working with a client through an agency. Alicia Scott and I are working for the same client as remote medical coders. There is no coding with CPT and HCPCS, just ICD-9 and it is fun if you enjoy ICD-9 coding. By the way, welcome to the forum, Becky.
Becky Curtis
Member
Carolyn, your job sounds great. I am interested in doing any kind of coding. I just need to get that start. My background is not in the business end of medicine but in the science and research side but at this point in my life I really want a change. Most companies are wanting experience and in my area I have not found any internships yet to get that experience. I know it will happen and I will keep learning while I search. One of the reasons I chose coding was the fact that there are so many avenues to explore and always new information to learn. Thanks for the welcome!
Ruth Sheets
CCO Moderator
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®)
I do HCC coding at my job! It's super awesome. I've been doing it for three months. HCC coding from my understanding, you can have CPC or other credentials to do it. All it is is a hierarchy system of icd coding in which helps determine reimbursement rates. If you are proficient in icd, then you can do HCC coding.