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The Importance of Adhering to HCC Guidelines

The Hierarchical Condition Categories (HCC) was developed and implemented by The Centers for Medicate and Medicaid (CMS) in order to create a risk adjustment methodology to provide adequate payment plans for patients opting for private health care. These codes are primarily based on the health expenditure risk profiles of the Medicare Advantage (MA) plan members;

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10 Common HCC Coding Mistakes

In response to the demand for improving the capture of chronic illness diagnoses for reimbursements, the Center for Medicare and Medicaid Services (CMS) mandated the development of the Hierarchical Categorical Condition (HCC) code system and implemented it in the year 2004. The incorporation of the HCC codes has helped drive CMS payments to Medicare Advantage (MA) members.

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