HCC Blog by Caridad

  These are the HCC categories in CMS-HCC V28.  CMS-HCC v28 HCC 35 Pancreas Transplant Status   HCC 36 Diabetes With Severe Acute Complications (rarely occur in outpatient setting)   HCC 37 Diabetes With Chronic Complications (higher level of severity of illness)   HCC 38 Diabetes With Glycemic, Unspecified, or No Complications   They all provide the same impact to the risk adjustment factor (RAF) score. The previous extra bump in risk adjustment factor for diabetic complications has been removed in this version.   Document linkage of diabetes to any and all manifestations.    2024 payments are based on 2023 dates of service. Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either t

  Congressional Testimony: The Honorable Christi A. Grimm, Inspector General for the U.S. Department of Health and Human Services, testifies before the United States House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: "Examining How Improper Payments Cost Taxpayers Billions and Weaken Medicare and Medicaid.”   Watch the Testimony Video  https://www.youtube.com/watch?v=UpquPVaQrH8 Read the Testimony  https://oig.hhs.gov/documents/testimony/9865/ig-grimm-testimony-04162024.pdf Interesting time stamps: 36:07 opening statement Krisiti Grimm on Improper payments 46:45 Opening statement Dr. Chernew, chair of Medicare Payment Advisory Commission (MedPAC) 55:02 Mr. Griffith statements and question to Ms. Grimm 55:30 Krisiti Grimm response 57:41 question on how medicare advantage payments are calculated, enrollee risk score calculations and calculation of coverage payments 1:00:43 question of Ms. Grimm – reporting requirements 1:01:11 reply (ch

  Learn about the financial relationships that doctors and other healthcare providers have with drug and medical device companies. 2022 data is available