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Hierarchical Condition Categories (HCCs) Release o...

Hierarchical Condition Categories (HCCs) which is CMS’ risk adjustment reimbursement methodology for Medicare Advantage (MA) (Medicare Part C) has undergone a significant overhaul for CY 2024 in the form of the release of a new model version. The Need for a New Model CMS has explained the rationale for a new model as follows: “In the MA payment system, all diagnosis codes are mapped to categories of diagnoses (called HCCs, Hierarchical Condition Categories) that are clinically related and have similar ability to predict Medicare costs. The existing HCCs (used in the current 2020 model) are built using ICD-9 codes. However, ever since the heal...

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    Hierarchical Condition Categories (HCCs)...

    Hierarchical Condition Categories (HCCs) which is CMS’ risk adjus...

    Feb 27, 2024

    “Code First” Instructional Notes in ICD-...

    Instructional notes within ICD-10-CM are not new. Coders have bee...

    ICD-10-CM Code Updates, April 2024

    As you know, CMS and the CDC release the majority of code changes...

    ICD-10-PCS Code Updates, April 2024

    In this Coding Tip, we present the new ICD-10-PCS procedure codes...

    Feb 22, 2024

    Periprosthetic Fracture Reporting and Se...

    There are approximately 6.3 million fractures reported each year ...

    Feb 21, 2024

    Admission Solely vs Chiefly for Chemothe...

    For FY 2024, the Official Guidelines for Coding and Reporting of ...

    Feb 20, 2024

    What is the Jada Device?

    Many coders who are coding obstetric cases are seeing a new devic...


    Medical Coding Tips

    Jul 06, 2022

    Coding Diabetes Mellitus with Assumed Conditions

    Diabetes continues to be a challenge for coders since the ne...

    May 30, 2023

    Acute Renal/Kidney Failure/Injury vs Dehydration a...

    Patients being admitted for acute renal failure due to dehyd...

    Feb 08, 2024

    Coding Diagnoses on Outpatient Encounters

    This coding tip is intended to clear up any confusion regard...

    Nov 08, 2019

    Sequencing the Diagnosis of Sepsis

    As discussed in Part 1 of this series, sepsis is a common di...


    Annual Code Updates

    ICD-10-CM Code Updates, April 2024

    As you know, CMS and the CDC release the majority of code ch...

    2024 CPT Code Updates

    This is a summary of the new CPT codes and HOPPS changes for...

    2024 ICD-10-CM, ICD-10-PCS Codes and IPPS Changes

    It is that time of year again where the new codes for the ne...

    ICD-10-PCS Code Updates, April 2024

    In this Coding Tip, we present the new ICD-10-PCS procedure ...

    Industry News

    Inpatient Coding of Probable Diagnoses

    The rules about coding probable, possible and questionable d...

    ICD-10-CM Code Updates, April 2024

    As you know, CMS and the CDC release the majority of code ch...

    Uncontrolled Diabetes Mellitus in ICD-10

    How do coders report uncontrolled DM in ICD-10-CM? First, co...

    Covid-19 Coding

    Update - Coding COVID-19 When the Test is Negative

    Updates as of 1/01/21: As you may know, assigning the approp...

    Covid-19 Diagnosis Coding Common Scenarios

    With the proliferation of COVID-19 cases, we thought we woul...

    Z Code Reporting for COVID-19

    Updates from 1/19/21 in green font.

    AHA COVID FAQs for ICD-10-PCS & New Technology

    Coders are instructed, at this time, to follow the AHA Frequ...


    Query Tips

    Jun 21, 2019

    Query Tip: When to Query for Sepsis

    Coders may find situations where a patient is documented as ...

    Sep 19, 2023

    How to Query for Pathology Results

    Tissue findings interpreted by a pathologist are not equival...

    Aug 23, 2019

    Query Tip: Writing a Query Question – Simple and C...

    The question asked in a physician query may be the most impo...

    Oct 11, 2023

    Query Tip: Avoiding a Leading Query – Don't Be Dir...

    "A leading query is one that is not supported by the clinica...

    Company News

    Introducing HIAlearn, an Online Medical Coding Edu...

    Accepted by AHIMA and AAPC, HIAlearn Serves as a One-Stop-Ed...

    Introducing HIA’s Cloud-Based Audit Software, Atom...

    Health Information Associates (HIA), celebrating their 30th ...

    Why Your Organization Needs an Online Medical Codi...

    HIA recently announced its internal Learning Management Syst...

    Nov 14, 2022

    HIA Announces Multiple Promotions Amidst Continued...

    Health Information Associates (HIA) is proud to announce mul...



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