Extend your CDI efforts to Medicare HCCs

by Gloryanne Bryant, RHIA, RHIT, CCS, CCDS

Approximately 11% of Medicare beneficiaries are now enrolled in private managed care health plans, with the rest in the traditional fee-for-service (FFS) programs. Did you know that Medicare Advantage (MA) payment methodology is driven by documentation and ICD-9-CM diagnosis codes? Like most aspects of our healthcare system, there are great complexities. In this article, I want to share with you some basics about MA Hierarchical Condition Categories (HCC) and the ICD-9-CM codes behind them.