HCC: Fundamentals of Hierarchical Condition Categories



Go beyond just the diagnoses — really understand the methodology behind HCCs! Prepare for the future of healthcare reimbursement with HCC: Fundamentals of Hierarchical Condition Categories, by nationally recognized HCC authority Rose T. Dunn, MBA, RHIA, CPA, FACHE. Course includes optional hands-on “Abstract & Code It!” exercises to reinforce learning (requires textbook).

CEUs:  7.5    7.5 AHIMA    7.5 AAPC
Included in eLearning Library. Price per person. Group rates available.

Designed for the experienced coding professional who is ready to really understand the methodology behind HCCs, you can close the loop for greater compensation.

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

HCC: Fundamentals of Hierarchical Condition Categories will provide you with the 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

Are you looking for hands-on practice in HCCs? Course includes optional hands-on “Abstract & Code It!” exercises to reinforce learning (requires textbook).

HCC: Fundamentals of Hierarchical Condition Categories

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

Lesson 2:
Common HCC Models
Pharmacy HCCs

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
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

Lesson 8:
Initial Validation Audits
Risk Adjustment Validation Audits
Frequency and Sample
Common Findings
Appeal Options

The level of effort to complete this course, start to finish, is equivalent to 7.5 CEUs and should take you approximately 7.5-22.5 hours to complete. Remember: You have access to the course materials for the full 16-week enrollment period and we encourage you to re-review any materials that are helpful to you.

Certificate of Completion
Upon successful completion of the course work, student will be able to download a Libman Education Certificate of Completion. The Certificate of Completion will list the course as awarding 7.5 CEUs.

This course has been approved for continuing education units (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.

AAPC: 7.5 CEUs
This program has the prior approval of AAPC for continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

  • WebinarPlus™ multimedia and interactive online course promotes engagement with challenging materials while offering independent self-study.
  • Teaching methods including audio and video files, diagrams, and animations to accommodate different learning styles. Where appropriate, the Merck Manual Professional Version supplements course materials with in-depth descriptions of diagnoses and/or procedures.
  • Knowledge checks and/or final assessment ensure mastery of material.
  • Online Flexibility! Materials available via secure Learning Management System (LMS). 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.
  • Price listed is per person/per course. Group rates available upon request.

Special pricing available for groups. Train your entire team!

How Many In Your Group? Group Discount %
1 Retail Price
2-4 5% Discount
5-20 10% Discount
21+ Contact Us for Your Custom Price Quote:
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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.

“I completed HCC Fundamentals this afternoon. Content was excellent! Much greater detail than I have seen in the past. Also reference information that I want to follow-up on. I sent an email to my colleagues and recommended they consider this training for the coming year. My phone started ringing immediately; the consensus is: Rose Dunn is phenomenal and they would take any training she has to offer. Again, thoroughly enjoyed the training.” — Anonymous

“I love this course, this is good for me and I am learning because my AAPC course didn’t cover half of this” — Melissa M.

“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

“The speaker is awesome and has great voice and I love the colors and the design of it” — student

“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

“LOVEEE Libman! Very happy with the classes I’ve taken.” — Linda C.

“I love the courses at Libman Education.” — Joanne S., CCS

“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

“Any of Libman Education’s courses are worth time and cost. Always walk away with a useable, clarity or reinforcement of subject matter.”


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  • HCC Problem Lists: Challenges and Opportunities


    Are your problem lists a problem? Providers have enough documentation burdens already. For providers, maintaining problem lists takes a backseat to patient care…as it should. However, an up-to-date and accurate problem list can facilitate patient safety and care as well as being a key aspect of some risk adjustment contracts.  HIM and CDI specialists have a role to play.

    HCC Problem Lists: Challenges and Opportunities will address your role in supporting this critical aspect of clinical documentation:

    • Establish and support a process of annual review to ensure the problem list is current and reflected in the provider’s documentation
    • On going support for problem list accuracy:  Coders and CDI Specialists may query providers or advise them on completeness of documentation
    • How to improve your annual re-set recovery for Medicare Advantage patients
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    HCC Quick Reference Guide


    The HCC Quick Reference Guide is a useful tool to communicate quickly and clearly to your providers the essential documentation necessary to support HCC diagnoses. Delivered as a downloadable and printable .pdf, the HCC Quick Reference Guide features straight-forward instruction for providers in 15 specialties.

    The HCC Quick Reference Guide includes the diagnostic statements that must be documented to support correct coding of the HCC. There are no ICD-10-CM codes in the course; just guidance on what to document.

    Designed to be shared with your providers, the HCC Quick Reference Guide is a unique product, organized by specialty to make the guidance more user-friendly and the information more accessible. The HCC Quick Reference Guide is ideal for Clinical Documentation Integrity specialists, any coder who provides HCC documentation guidance to providers, or any provider who wants succinct guidance on mastering HCCs.

    The HCC Quick Reference Guide provides a concise set of information for each specialty:

    • Cardiovascular
    • Dermatology
    • Endocrinology
    • Gastroenterology
    • Hematology
    • Internal Medicine – Family Practice
    • Mental Health and Substance Abuse
    • Nephrology and Urology
    • Neurology
    • Oncology
    • Ophthalmology
    • Orthopedics
    • Pulmonology
    • Rheumatology
    • Trauma

    Each guide provides the key information needed for accurate HCC documentation of diagnoses in that specialty:

    • HCC hierarchy
    • Disease Interaction (Institutional)
    • Disabled/Disease Interaction
    • Alphabetical listing of diagnostic statements

    Plus!  Designed to be shared with your providers, the HCC Quick Reference Guide provides additional instruction in straightforward language on how HCCs work and how it affects the provider’s documentation including:

    • Risk Adjustment Factors (RAF)
    • Coefficients
    • Trumping