New Content on HCCUniversity.com

There’s been a lot of activity on HCC University!  Since my last email, we’ve posted several new things:

First, an updated Pocket Documentation Tip Sheet, which includes instructions for ICD-10 guidelines.  This tip sheet can be printed and folded to fit in a lab coat pocket, and will help clinicians meet some of the documentation challenges they face on a daily basis.

Next, we’ve updated the Primary Care Superbill.  As before, it includes CPT  II codes that help you meet both 5 Star AND Fee-for-service PQRS requirements!  Now, it’s been updated to include ICD-10 codes for many common illnesses seen in a Primary Care practice.

Finally, we’ve posted a new presentation on ICD-10 Guidelines.  This brief, physician oriented presentation will help providers understand the rules of ICD-10, where to find them, and why they must be followed.  It shouldn’t take any more than 20 minutes to go through, but provides a wealth of information to help you choose the correct ICD-10 code. 

For all of you who have asked---yes, the Risk Score Calculator will be updated for 2016 payment year.  We’re in the midst of doing that now, and hope to have it available right after the first of the year.  

As always, if you have suggestions for tools for HCC University, please let me know. 

If you have coding questions, please contact us at Coding@scanhealthplan.com.

Happy Holidays all!  And a wonderful 2016!

Best,

Stacey

Can You Code From a Problem List?

Today we posted a collections of documents from CMS. These documents were Questions and Answers from a series of CMS Risk Adjustment  User Group Calls.  Among the answers is a question we get very frequently--Is it okay to code from a problem list?  To find out, check out the CMS User Group Q and A's on HCC University.

Risk Score Calculator Updated with 2014 Model

The Risk Score Calculator on HCCUniversity.com has been updated with the 2014 CMS-HCC Risk Score Calculator.

The calculator will allow you to calculate risk scores for services on or after 4-1-2013.  The updated calculator shows the components of the 2013 (25%) model and the 2014 (75%) model, and the final blended score.

We hope you find this new tool useful.

What's New on HCC U?

We've updated the Risk Score Calculator on the Tools page, so you can display 2013 risk scores.   You can view the calculator here.

In addition, we've updated the presentation explaining the new requirements for the Annual Wellness Visit.  There's also a form, and the ICE Health Risk Assessment form, to help you document the patients' Annual Wellness Visit.

That's it for now.  If there are new tools you'd like to see on HCC University, you can contact us at coding@scanhealthplan.com.

New Tools on HCC University!

We sometimes receive diagnosis codes that are unlikely, based on the place of service.  These codes represent conditions that are of such severity that they usually require hospitalization.  We've prepared several short handouts to help physicians and other clinicians understand the correct use of these codes.  Most of them can be printed on a half sheet of paper (we recommend an eye catching color like yellow or bright blue for impact) to share with your clinicians. 

Choose from:

Sepsis Fact Sheet

Acute MI Fact Sheet

Unstable Angina/Acute Coronary Syndrome Fact Sheet

Acute Respiratory Failure Fact Sheet

Acute CVA Fact Sheet

Download them now on the Tools Page.  Scroll down to "Downloadable Tools".

Recently Posted Tools and Documents on HCC University

We want to ensure that HCC University and the HCC University blog are your favorite risk adjustment related websites.  So, over the past few weeks, we’ve posted a large number of tools and documents on HCCUniversity.com.  Since none of us has time to check every day, we thought we’d give you an overview of what’s gone up on the site recently.

Full Encounter Data Information -  ICD 10/Full Encounter Data Page

Updates from the CMS Work Group Conference Calls have been posted:

Capitated and Staff Model Plans Summary Notes

Encounter Data Newsletter - Quarter 2

Encounter Data Work Group Summary Notes for Editing and Reporting: Key Findings and Recommendations #2

Third Party Submitters Work Group

Risk Adjustment Tools

2011 HCC List-Diagnosis Code Grouping - this file shows diagnosis codes grouped by HCC category.  Categories or codes with problematic guidelines have documentation and coding notes. - Excel file here.

Risk Adjustment Data Validation Tools

This checklist was used in the last National RADV to assist health plans in selecting the "One Best Medical Record" for submission.  Download here.

CMS Pilot RADV Findings—for services rendered July 1, 2001 through June 30, 2002, Published July 27, 2004.  Study findings here.

Annual Wellness Visit Tools

Annual Wellness Visit Presentation --Power Point Presentation.

Annual Wellness Visit form, instructions, and USPSTF Preventive services schedule - Zip File Here.

If you have questions, comments, or suggestions for new tools, leave us a comment here, or email us at coding@scanhealthplan.com.