HCC Blog by Caridad

These are some links to resources on the RADV program available from CMS.  From the main page:   Research, Statistics, Data & Systems>  Medicare Risk Adjustment Data Validation Program > Resources https://www.cms.gov/research-statistics-data-and-systems/monitoring-programs/medicare-risk-adjustment-data-validation-program/resources Scroll down this page to Downloads. This is where you will find the Medical Record Review Guidance 2020 document.  Here is the direct link:   https://www.cms.gov/files/document/medical-record-reviewer-guidance-january-2020.pdf-0 Happy reading! 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 the written law or regulations.  The information p

  Highlights for me:  Page 65-115 page 163 Timely Follow-up After Acute Exacerbations of Chronic Conditions (Part C) page 184 HCC categories (aka Disease Coefficients) page 195 Table VIII-4. 2024 CMS-HCC Model with Disease Hierarchies https://www.cms.gov/files/document/2024-announcement-pdf.pdf 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 the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the date of publication.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), released the Calendar Year (CY) 2024 Medicare Advantage (MA) and Part D Rate Announcement. The 2024 Rate Announcement can be viewed at   https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents  and selecting “2024 Announcement.” https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents 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 the written law or regulations.  The information presented herein is for general informational purposes only and is accurate as of the date of publica