Fundamentals of HCC Coding

Rose T. Dunn, MBA, RHIA, CPA, FACHE

$295.00

Go beyond just the diagnoses — really understand the methodology behind HCCs! Prepare for the future of healthcare reimbursement with Fundamentals of HCC Coding, by nationally recognized HCC authority Rose T. Dunn, MBA, RHIA, CPA, FACHE.

CEUs:     7.5 AHIMA      7.5 AAPC
Included in eLearning Library

Go beyond just the diagnoses — really understand the methodology behind HCCs!

Hierarchical Condition Categories (HCCs) are utilized by Medicare Advantage and Affordable Care Act (Obamacare) payers for approximately 30 million individuals currently.  Use of HCCs is projected to grow significantly in coming years.

Prepare for the future of healthcare reimbursement with Fundamentals of HCC Coding. The online, self-paced course provides comprehensive instruction to ensure complete and accurate HCC coding to improve data quality and ensure appropriate reimbursement.

Interested in attaining your CRC? Fundamentals of HCC Coding will prepare you for AAPC’s Certified Risk Adjustment Coder (CRC) credential with in-depth content specific to the exam’s requirements.

Providers and Hospitals, especially those with employed doctors or with Accountable Care Organization (ACO) arrangements utilizing HCC methodology, need individuals with in-depth knowledge and command of the HCC system to ensure coding is accurate, supported by documentation, and that reimbursement is appropriate.

  • Go beyond just diagnoses – really understand the methodology behind HCCs
  • Learn how to use problem lists, past medical history, and medication lists to identify all the HCC codes for every encounter
  • Put on your CDI ‘hat’ and work with providers to ensure complete and thorough documentation to support HCC diagnoses
  • Identify HCC-specific coding guidance for the coding professionals on your team
  • Learn how HCC diagnoses impact the calculation of the risk adjustment factor and the resulting reimbursement for your facility
  • Support the efforts of the hospital contracting team to ensure appropriate and fair reimbursement
  • Effectively manage the impact of external auditors
  • Multimedia and interactive online course offering independent self-study.
  • Knowledge checks and/or final assessment ensure mastery of material.
  • Online Flexibility! Materials available 24/7. Work at your own pace — save time and travel costs.
  • Earn Libman Education Certificate of Completion and CEUs.
  • To receive CEU credit, students must achieve a passing rate on the course assessment(s).
  • Course is self-paced. For planning purposes, assume 1-3 hours required for each CEU.
  • Unlimited course access during enrollment period. For courses offering greater than one CEU, enrollment period is 16 weeks. For courses offering one or fewer CEUs, enrollment period is 4 weeks. Courses purchased as a bundle or package may have a longer enrollment period.
  • Extensions to the enrollment period are available. Contact Libman Education for pricing.
  • Financing available through PayPal Credit.
  • Price listed is per person/per course. Group rates available upon request.

Fundamentals of HCC Coding Course Syllabus

Lesson 1:
History of Risk Adjustment
Why HCCs were implemented
Structure of HCCs
Where do we find HCCs?

Lesson 2:
Common HCC Models
CMS-HCCs
ESRD HCCs
PACE HCCs
Pharmacy HCCs
HHS-HHCs
CDPS

Lesson 3:
Foundational Principles of HCCs
Understanding the Diagnosis to CMS-HCC Map
Understanding the CMS-HCC Relative Factors Grid

Lesson 4:
How are HCCs Calculated
Medications
CPT® Influence
CMS0HCC Relative Factors

Lesson 5:
Reimbursement Methodology
Applying the Denominator
Calculating the Risk Adjustment Factor
All Condition Count HCC Methodology

Lesson 6:
Understanding the claim data and reimbursement flow
Comprehending the terminology

Lesson 7:
Documentation Requirements
Medical Record Reviewer Guidelines (RADV Checklist)
Physician Documentation (MEAT/TAMPER)
The role of the Clinical Documentation Integrity Specialist
The role of the Clinical Record Analyst

Lessons 8-11:
Reading and Practice

Lesson 12:
Initial Validation Audits
Risk Adjustment Validation Audits
Frequency and Sample
Common Findings
Appeal Options

Rose T. Dunn, MBA, RHIA, CPA, FACHE

Rose Dunn is the Chief Operating Officer of First Class Solutions, Inc., a healthcare information management leader since 1988, offering professional consulting services in health information management operations and information governance issues, as well as coding support, coding quality reviews, privacy/security guidance, temporary (interim) management, revenue cycle oversight, and accreditation preparation. Rose jumped into the weeds of ICD-10 more than 10 years before it was implemented and has been getting back into the weeds of HCCs for the last 2 years. Rose is the author of Libman Education’s online course: Fundamentals of HCC Coding as well as “The Revenue Integrity Manager’s Guidebook” available from the National Association of Healthcare Revenue Integrity and other books on coding management and auditing. Ms. Dunn holds a B.S. and M.B.A. from Saint Louis University.

“The quality of the courses that Libman presents is excellent” — Pamela S., RN, BSN, MSN, CCDS, Director, Clinical Documentation Improvement, Sharp Healthcare

“I tell everyone about Libman. I find that you have a very wide variety of choices in education that is actually needed and not so many things that aren’t really needed and can be mind boggling just trying to sift through it. Your website is well organized and everything offered is so well laid out and very informative as far as what you are getting, what I need and a very thorough write-up on everything offered. I’m so thrilled to have found your site!” — Sharon T

“I truly thank you Libman Group for your wonderful courses that have contributed to my success.” — Leslie Jay Corn, CCS, CPC, CCA/ER Coding Analyst/Boston Medical Center OR LogixHealth

“I’m pleasantly surprised at your response … really didn’t think I would receive anything at all, so, thank you! I believe that alone says a lot for Libman Education. I would recommend you to other coding professionals.” — Jennifer Jones, CPC

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“Libman has exceeded my expectations so far in every way, with the content of courses, but the hands on with the instructors is one of the best and most genius things to offer! All other companies I’ve seen in my 12 years in this field do not offer this invaluable service with their education. Answers to questions on education content is something that was desperately needed, but to my knowledge, it was/is not offered anywhere else and this is what sets Libman apart from the rest. Also, your high quality education and very knowledgeable instructors.” — coding student

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