Risky Business: HCC Coding
In healthcare, providers face a challenge when it comes to enhancing risk scores for improved patient care within Value-Based Care. This challenge has a direct impact on the quality of care patients receive. It's evident that providers need to gain knowledge about effective risk score enhancement but encounter difficulties in applying these strategies in their daily practice. To address these challenges, this presentation aims to guide providers in utilizing the risk adjustment model, understanding documentation requirements, recognizing the components of risk scores, and reviewing high-yield codes. The goal is to empower providers to deliver more patient-centered care within the Value-Based Care framework while overcoming these obstacles.
Activity Information
How to Claim Credit
You may claim credit after watching this activity.
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Needs Statement
In healthcare, providers face a challenge when it comes to enhancing risk scores for improved patient care within Value-Based Care. This challenge has a direct impact on the quality of care patients receive. It's evident that providers need to gain knowledge about effective risk score enhancement but encounter difficulties in applying these strategies in their daily practice. To address these challenges, this presentation aims to guide providers in utilizing the risk adjustment model, understanding documentation requirements, recognizing the components of risk scores, and reviewing high-yield codes. The goal is to empower providers to deliver more patient-centered care within the Value-Based Care framework while overcoming these obstacles.
Educational Objectives
At the conclusion of the session, the participants should be able to:
- Utilize the risk adjustment model to assess and predict healthcare costs.
- List the components that constitute risk scores in healthcare assessment.
- Review high-yield ICD10 diagnoses for risk scores.
- Identify the documentation requirements for a progress note to apply ICD-10 codes for Hierarchical Condition Category (HCC) purposes.
Target Audience
Professional Categories
- Physicians
- Nurses
- Other Health Professionals
Specialties
- Family and Community Medicine
- Internal Medicine
Interest Groups
- Primary Care
- Quality Improvement and Patient Safety
Activity Evaluation
Evaluation by questionnaire will address program content, presentation, and possible bias.
Educational Methods
- Lectures
- Other
Accreditation/Credit Designation
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Baylor College of Medicine and Texas Health Network CIN. Baylor College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Baylor College of Medicine designates this enduring material activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Activity Director
-
Angela Nunnery, M.D.
Assistant Professor of Family and Community Medicine
Baylor St. Luke’s Medical Group
Term of Approval
March 1, 2024 through March 31, 2026. Original release date: March 1, 2024.
Disclosure Policy
Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.
In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.
In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.
BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.
All of the relevant financial relationships listed for these individuals have been mitigated.
Disclosures
The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:
Presenters
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Megan Harkey, M.H.A.
Vice President - Clinically Integrated Network
CommonSpirit Health
Disclosure:
Nothing to disclose.
-
Tracy Maddox, J.D., M.S.N., R.N.
Division Director, Care Management
CHI St. Luke’s Health, CommonSpirit Health
Disclosure:
Nothing to disclose.
-
Angela Nunnery, M.D.
Assistant Professor of Family and Community Medicine
Baylor St. Luke’s Medical Group
Disclosure:
Nothing to disclose.
-
Tyler Peavy, M.H.A.
Director, Clinical Integration Networks
CommonSpirit Health
Disclosure:
Nothing to disclose.
Activity Director
-
Angela Nunnery, M.D.
Assistant Professor of Family and Community Medicine
Baylor St. Luke’s Medical Group
Disclosure:
Nothing to disclose.
Planning Committee Members
-
Megan Harkey, M.H.A.
Vice President - Clinically Integrated Network
CommonSpirit Health
Disclosure:
Nothing to disclose.
-
Royd Hernandez, M.H.A.
Division Director, Data Analytics
CommonSpirit Health
Disclosure:
Nothing to disclose.
-
Angela Nunnery, M.D.
Assistant Professor of Family and Community Medicine
Baylor St. Luke’s Medical Group
Disclosure:
Nothing to disclose.
-
Tracy Maddox, J.D., M.S.N., R.N.
Division Director, Care Management
CHI St. Luke’s Health, CommonSpirit Health
Disclosure:
Nothing to disclose.
-
Tyler Peavy, M.H.A.
Director, Clinical Integration Networks
CommonSpirit Health
Disclosure:
Nothing to disclose.