From concept to application, you'll learn about the complexities of HCC coding, diagnoses codes and risk codes, the interplay of quality all the way through to revenue.

  • Navigate the coding and documentation paradigm shift
  • Master the mechanics of hierarchical coding
  • Decode the inner-dependencies of HCC coding---diagnoses codes, risk scores and revenue
  • Understanding the rules of engagement to evoke evidentiary data needed
  • Sharpen your skills with RADV mock audit fire drills
  • Distinguish how coding impacts the larger health plan organization from a financial context
  • Demystify the fine line between coding and over coding
  • Identify the common coding challenges and learn how to become a troubleshooter for your provider offices

Our six-hour online course covers the entire HCC coding landscape

Module 1: Why Do We Have Risk Adjustment? Introduction

  • Define the purpose of Risk Adjustment in CMS payments
  • Uncover health care program types that use Risk Adjustment for payments 

Module 2: Risk Adjustment Overview for the Coder

  • Review the CMS HCC timeline of payments
  • Understand HCC categories and how to calculate your RAF score
  • Learn how six disease interactions increase a RAF score

Module 3: Documentation and Coding for Risk Adjustment

  • Understand the difference between coding history v. active conditions
  • Recognize the most common guideline changes for 2017/18 ICD-10-CM

Module 4: Medical Record Requirements for Mock Audits

  • Recognize the steps and identify criteria required for a mock audit
  • Understand how to use mock audit results to reduce future risks

Module 5: Concurrent Workflows to Reduce Risk

  • Understand strategic initiatives that can be implemented for improved reporting and provider support
  • Review workflow processes in the healthplan and provider office to reduce risks of under-reporting & over-reporting

Module 6: HCC Coding-Coding Impacts

  • Review case study examples to determine missed conditions and RADV risks


This program has been approved for 6 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.


$700 Enroll Now