Boyd: What are you talking about when you’re talking about HCC Coding?

HCC Medical Coding – Video

Alicia: HCC Coding is a type of specialty coding and it’s hierarchical coding and that’s done for Medicare Advantage. It’s only done for Medicare patients and eventually it’s going to move over. Right now reimbursement in mainstream for physician practice is based on CPT codes or the procedures that they do for you, but Medicare it’s based on your diagnoses. And it’s all about projection, so they’re projecting how much money they need to set aside for you so that they don’t run out; and the sicker you are, the more money they set aside for you.

So, if you take Medicare Advantage to the physicians it behooves them to take very sick patients because they get – you know, more money is set aside for a sick patient. You want people to be healthy and everything, but if a person has hypertension, and they have Medicare; and a person has hypertension, diabetes and cholesterol, they’re going to get more money off of that person because they have to treat that person for those many diagnoses. And eventually, I suspect and there’s talk of that with the healthcare system going, the way it is, it will move to diagnosis reimbursement again versus the procedures. It was like that in the past, sometime before my time.

Learn More Information about HCC Medical Coding

What is HCC Coding? – Video

AAPC – HCC Coding

hcc medical coding


About the Author:

Alicia has been working in the medical field for over 20 years. She first learned about medical coding while working in a medical records department at a resort town hospital near where she was raised. Through the years she has held several jobs in the medical field from, CNA, EMT, Pharmacy technician and Medial Records Abstractor and Analyst. Outside of the medical field she has worked as a Real Estate agent, and owned her own on-line retail business. The medical field has always been where she felt the most comfortable. Alicia has taught medical coding, billing and medical law and ethics at a private college. She also did contract work in HCC Risk Adjustment and discovered she really enjoyed ICD work. Because she loves to learn Alicia is working towards her Masters in Health Care Administration with an emphasis on education. Having taken many online classes through the years to complete her degree she feels very comfortable with both face to face and on-line learning. Alicia will tell you that not only does she love medical coding but she has a passion for teaching it. Alicia lives in the middle of Texas with her husband who is a Pastor, five of her six children, three dogs and two cats.

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