https://www.magnetmail.net/actions/email_web_version.cfm?recipient_id=2408638582&message_id=14204985&user_id=AHIMA&group_id=0&jobid=37208444 May 2017 An Inside Look at HCCs and Risk Adjustment Data Validation: Part 1 By Monica Watson, RHIA, CPC, CCS, CCS-P, CPMA, CIC, CRC, and Sharon Easterling, MHA, RHIA, CCS, CDIP, CRC, FAHIMA Regulatory audits come in all shapes and sizes. From the Office of Inspector General (OIG) to Recovery Audit Contractors (RAC), to Zone Program Integrity Contractor (ZPIC), to Risk Adjustment Data Validation (RADV), each audit has a core objective: to ensure proper payments. The most common audits are coding audits and medical necessity audits, where the audit places the burden of proof on the claim’s submitter to demonstrate the coding is accurate and the condition is supported. Best practice encourages organizations to get it right before it goes out the door and incorporate monitoring through internal audit programs that mitigat...