Hierarchical Condition Category (HCC) is a term that describes the grouping of similar diagnoses into one related category to be used in a risk adjustment model

Sep 2, 2025 · Accurate HCC coding is essential for fair reimbursement, compliance, and quality patient care. Avoiding errors, leveraging technology, and staying updated on regulations ensure precise risk …

Apr 1, 2019 · HCC Coding Basics HCC is a risk adjustment model used by the Centers for Medicare & Medicaid Services (CMS) for Medicare Advantage (Part C) contract rates. Risk adjustment is a …

Implementing an effective HCC coding system is essential to strong financial and clinical performance under value-based reimbursement contracts.

Dec 1, 2015 · HCC 18 in Medicare 2014 CMS HCC Model Category Diabetes is one of the most frequently under-coded conditions in risk adjustment. Many providers default to diabetes without …

Risk Adjustment Search Tool Use the Risk Adjustment Search Tool to quickly find a hierarchical condition category (HCC) assignment. Enter the ICD-10-CM code or the diagnosis for results in three …

Jul 20, 2011 · What Medicare Risk Adjustment HCC coding is all about. How providers need to be more specific in their documentation and support their diagnosis codes especially for the diagnoses that …

Jan 1, 2010 · Much like hierarchical condition category (HCC) coding for payers (see “Validate Coding Data with CDIPs in Medicare Risk Adjustment,” Coding Edge, August 2009, pages 20-23), the …

Nov 1, 2023 · This, in turn, ensures accurate hierarchical condition category (HCC) coding and proper risk adjustment, thereby protecting the outcomes of the patient, the provider, and the payer.

Dec 10, 2015 · The HHS-HCC risk adjustment model is a concurrent model, which means it uses diagnoses from a time period to predict cost in that same period. All data reporting for the HHS …