Risk adjusted reimbursement is based on the health status of the patient as summarized by certain ICD-10-CM codes reported by the provider. The reporting timeframe is twice per year in order to maintain stable funding; PCPs should assess, document and code to the highest level of specificity all of the patient’s chronic conditions in visits between January 1st and June 30th and again between July 1st and December 31st. We always recommend, where possible, to assess and report all the MRA conditions in the first visit of the period; this allows providers to focus on the chief complaint on subsequent visits along with any chronic conditions that are relevant.
Since we have now entered the second semester of the year, we are reminding all providers to assess all of the patient’s risk adjusted or MRA conditions with – what we call – bulletproof documentation. CCG has two recent blogs on this topic: General documentation tips can be found here and E/M Services are explained here.
Remember that MRA conditions require a face-to-face visit, or in the this New Normal of COVID, where patients may be reluctant to come to the office, a telehealth visit with audio AND video. Proper documentation of telehealth is covered in this blog.