Widespread changes are coming in 2024 for the CMS risk adjustment model. Although the final details, the impact of the changes, and what that means for risk adjustment are yet to be seen, over the next couple of weeks, DoctusTech will highlight in depth the proposed impact of:
The V24 model of managed care used ICD-9 codes as its basis for HCC categorization. CMS has now transitioned to ICD-10 as its reference and allowed for more specificity in charting and grouping. The total number of HCCs increased from 86 to 115 while the total number of codes that map to an HCC diagnosis decreased from 9,797 codes to 7,770. CMS separates the 115 HCCs into 26 groupings of conditions, and conditional hierarchies are contained in these groupings as well. Over the next couple of weeks, we will discuss the changes from V24 to V28, going into detail about 7 categories a week.