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HCC Auditing: Identifying Lost Revenue Associated with Skeleton RAF

HCC Auditing: Identifying Lost Revenue Associated with Skeleton RAF

by Rose T. Dunn, MBA, RHIA, CPA, FACHE Why are physician practices reluctant to code all conditions? I still see physician offices submitting claims with only four diagnoses (sometimes fewer). The limitation of linking four conditions to a test or service has been interpreted by some providers as a limit on the number of diagnoses […]

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Hierarchical Condition Categories Driving Demand for Accurate Coding

Hierarchical Condition Categories Driving Demand for Accurate Coding

by Rose T. Dunn, MBA, RHIA, CPA, FACHE Even though the Hierarchical Condition Categories (HCCs) have been around since 2004, the interest in this categorization methodology by coding professionals is relatively recent. Used by Medicare Advantage, Medicaid, and risk sharing programs, HCCs serve as the basis of defining the complexity of the mix of patients […]

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