Ask An Expert: hierarchical condition categories (HCCs)
| Q: | When an MRA patient has several diabetic manifestations, do I need to report all the diabetic codes even though there is a hierarchy? |
| A: |
Yes. The correct way to code the manifestation is with its associated diabetic ‘category.’ So, if the patient has CKD III, retinopathy and PVD, all secondary to diabetes, the correct ICD-9-CM codes to report are: 250.4x, 585.3, 250.5x, 362.01, 250.7x, … Read Full Post |
| Q: | How does risk adjusted payment work with regard to hierarchies? I’ve heard that some ICD-9-CM codes ‘trump’ others. |
| A: |
Risk adjusted diagnoses are classified into hierarchical condition categories (HCCs). Some HCCs are in a hierarchy. Imagine the HCCs on a ladder, if you will. As you climb up the HCC ladder, the HCCs on the lower rungs are ‘replaced’ … Read Full Post |