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American Association of Colleges of Pharmacy

HCC Coding and Documentation: A Doctors View

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Overview / Abstract:

"I don't need to know about Medicare Part C and HCC coding, it doesn't affect me." This might have been true at one point but now both Medicare and Medicare Part C are dependent on HCC rules and regulations. More than 1 in 4 Medicare patients nationally and 1 in 3 in many states are in the Medicare Part C model. Coders (and some doctors) must know part A and B rules and now it is just as important to be aware of Part C. This is the diagnosis-dependent capitated model that has doubled its enrollment in only the past few years.

You Will Learn:
Basics of the Hierarchical Condition Category (HCC) model and how it impacts all physician offices
Documentation requirements for diagnoses - requested for auditing purposes
How the EMR changes the type of documentation that can be used and where it can be found
Documentation tips that meet Medicare requirements, which can be taught to physicians to create a less intrusive work flow
Strategies for "refreshing" the diagnoses on a yearly basis, a must for success in the model


Sep 03, 2020


Informatics / Coding / Billing CE





Credits / Hours


Presenters / Authors / Faculty

Dr. James M Taylor is a Board Certified Family Medicine physician and Certified Professional Coder. He went into private practice in Xenia, Ohio and later joined Kaiser Permanente in Denver, Colorado, in 1995. He has served on the Electronic Health Record team for three years as a physician trainer and system administrator. He served as the Physician Director of Coding from 2002 to 2007 and is now the Medical Director of Revenue Cycle. He was recently elected to the Board of Directors for Kaiser’s physician group, the Colorado Permanente Medical Group.

Keywords / Search Terms

American Association of Colleges of Pharmacy

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