As a healthcare provider, you know the importance of accurately and consistently documenting diagnoses, but not just to align revenue – there is a far greater reason for specific, accurate HCC coding: patient care. One thing that is often overlooked when calculating RAF scores is the simple fact that Risk Adjustment Factor is the simplest way to track a patient’s critical health: how difficult will it be to keep this patient alive?
If you consider the RAF as an indicator of the life of your patient, and your patient population, then properly diagnosing, documenting, and calculating RAF makes a lot more sense. This simple number tells a complex story, and it is vital to the health and lives of your patients – which is why proper HCC documentation is critical, and having instant access to the right HCC code is of utmost importance.
One way that many clinicians have traditionally done this is by using HCC (Hierarchical Condition Category) coding cheat sheets. These sheets provide a list of diagnoses and the corresponding HCC codes, making it easy for clinicians to find the right code for a particular diagnosis.
While HCC coding cheat sheets can be useful in the short term, relying on them too heavily can lead to problems in the long run. Here are a few reasons why you may want to consider weaning your clinicians off of HCC coding cheat sheets:
Cheat sheets can be outdated: HCC codes change frequently, and cheat sheets may not always be updated to reflect the most current codes. This can lead to incorrect coding, which can result in denied claims or underpayment.
Cheat sheets can promote a lack of understanding: Clinicians who rely heavily on cheat sheets may not take the time to fully understand how HCC coding works. This can lead to errors in coding and a lack of confidence in their coding abilities.
Cheat sheets can be a crutch: It’s important for clinicians to be able to code diagnoses accurately without relying on cheat sheets. This requires a strong understanding of HCC coding and the ability to think critically about how to code different diagnoses.
So, how can you wean your clinicians off of HCC coding cheat sheets? Here are a few suggestions:
Provide enhanced training: Consider offering HCC coding training to your clinicians to help them understand the coding process and develop their coding skills. This can be done through in-person training sessions or online courses.
Encourage critical thinking: Encourage your clinicians to think critically about how to code diagnoses and to use resources like official coding guidelines and the ICD-10 manual to help them determine the correct codes.
Use coding software: Many electronic health record (EHR) systems have built-in coding tools that can help clinicians determine the correct codes for diagnoses. Encourage your clinicians to use these tools to help them become more confident and accurate in their coding.
By taking these steps, you can help your clinicians develop strong coding skills and break their reliance on HCC coding cheat sheets. This will lead to more accurate coding, better reimbursement, and improved patient care.