Proper hierarchical condition category (HCC) coding is crucial to paint the full picture of a patient’s health, particularly concerning the long-term complexity of treatments they’ll need for certain diagnoses.
Accurate data collection, along with complying with new rules for coding and implementing a clinical data coding solution like Ubiquity by Inferscience, is key to ensuring that HCCs and risk adjustment factor (RAF) scores are precise, and can therefore predict outcomes that may change the value of provided care.
In this guide, we’ll walk through tips for closing HCC coding gaps to help healthcare providers maximize reimbursements and prevent loss of revenue.
It’s important to ensure that data is collected and aggregated at all points, considering all sources. It’s best to use better forms, such as patient assessment forms (PAFs) or comprehensive health assessments (CHAs) to help collect more complete diagnoses at the point of care.
You can also practice better documentation by employing technology such as Ubiquity by Inferscience. This way, you can accurately capture and analyze data with minimized error.
Coding specificity is important in obtaining RAF scores. The practice should be encouraged among all physicians. They must be extra specific when documenting diagnoses to better assign values and determine risks.
Chronic conditions must be documented every year to be factored into risk adjustment calculations, so regular data revalidation is a must. Follow-ups must be made to keep track of any patient’s health conditions, and those who don’t get to visit their physicians annually should be flagged so that annual wellness check-ups can be scheduled.
When revalidating and reviewing data, it’s recommended to use automation tools to streamline workflows and ensure accurate HCC coding. These processes can be taxing, so leaving it to technology can save a lot of resources while generating better results.
Give your providers all the support they need to complete proper documentation and capture of HCCs. Provide them with adequate training and equip them with specialized automation tech to make their work more efficient. If necessary, add as much support staff as needed, including HCC coders, care coordinators, etc.
HCC tools, such as Inferscience’s Ubiquity electronic health record (EHR) agnostic tool, are a smart way to close HCC coding gaps. These techs are designed to be more effective in data collection and validation. Plus, they’re made to better perform HCC coding tasks.
Clinical coding is becoming more complex, leading to the inevitability of HCC coding gaps. That said, with the right tools and best practices, healthcare providers can address these challenges.
Ubiquity by Inferscience is a data extraction tool that helps you automate your HCC coding processes without interrupting your workflow. The EHR agnostic tool can analyze data in a patient’s chart from any web-based EHR and display HCC coding suggestions in an easy-to-read manner. Through this solution, providers can submit HCC tabs straight to the patient’s chart in the EHR.
References:
https://yes-himconsulting.com/specificity-in-documentation-and-coding-hccs/
