Risk Adjustment Documentation & Coding

Explore the evolution of value-based coding systems such as HCC and MIPS, and their impact on the coding process and reimbursement. Explore how the process differs from facility coding to pro-fee coding.  Review documentation requirements for compliance with programs such as HCC as well as review common administrative errors to avoid.  Coders will receive guidance on appropriate policies that maintain the integrity of coding while providing the information necessary to satisfy data collection protocols required for risk adjustment programs. 

Topics addressed include:

• A detailed explanation of the concept of risk adjustment and how it impacts coding
• Review multiple risk adjustment models and understand which impact facility coding and which impact pro-fee coding
• Understand how risk adjustment programs impact provider reimbursement
• Explore the impact of administrative processes upon coding, risk adjustment, and reimbursement
• Explore how to assess provider documentation from the standpoint of risk adjustment

CEUs:  AHIMA 6 hours.

Course Format: Video instruction, CMS links, and assessment to test understanding of the material

Course Time: 6 hours

Note: Text required (must purchase separately): Risk Adjustment Documentation & Coding, ISBN#: 978-1-62202-733-0. Publisher: American Medical Association.