HCC Blog by Caridad

This .pdf has an excellent description of HCC Models, V12, V22, V23 Chronic Condition Data Warehouse – CCW User Guide: Medicare Risk Score Files July 2018 Version 1.0 P 8, Version 12 (V12) was available through 2014. P 9, Version V21, V22 https://www.ccwdata.org/ documents/10280/19002246/ccw- medicare-risk-score-user- guide.pdf It can also be found off the home page, look for Analytic Guidance tab > then CCW Medicare Risk Score Files User Guide I am not affiliated with them in any way. Just sharing a good explanation I came across.

1 995 DOCUMENTATION GUIDELINESFOR EVALUATION AND MANAGEMENT SERVICES as it relates to Risk Adjustment we can refer to page 2 of the document, GENERAL PRINCIPLES OF MEDICAL RECORD DOCUMENTATION 3 elements to evaluative statement about the diagnosis/disease should include: 1. assessment 2. clinical impression, or diagnosis 3. plan for care The patient's progress, response to and changes in treatment, and revision of diagnosis should be documented. and in the section:  DOCUMENTATION OF THE COMPLEXITY OF MEDICAL DECISION MAKING on page 12, "For a presenting problem with an established diagnosis the record should reflect whether the problem is: a) improved, well controlled, resolving or resolved; or, b) inadequately controlled, worsening, or failing to change as expected.  For a presenting problem without an established diagnosis, the assessment or clinical impression may be stated in the form of a differential diagnoses or as "possible,” "probable,”...