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Optum HCC Boot Camp Update

What is a key component to risk stratification and budget setting for your Medicare and Medicare Advantage patients? The answer is HCC Coding.

Hierarchical Condition Category (HCC) codes are ICD-10 codes that allow Medicare to calculate the “burden of illness” in a patient. Patients with high HCC scores are more likely to have complications and require more services/care. Coding to the highest and most appropriate level of disease severity and specificity improves likelihood of accurately representing severity of illness in these patients.

On Thursday, January 26th, nearly 100 Primary Care Providers and staff members attended the HCC Coding “Boot Camp” sponsored by OptumCare. Dr. Tania Miedico, OptumCare’s Clinical Documentation and Quality Improvement Department national medical director, walked the SFHCP crowd through the fundamentals of HCC coding and documentation. The presentation stirred many questions and answers from the audience.

The SFHCP Regional Medical Directors will be presenting HCC Coding information at their 1st quarter Pod meetings with PCPs. SFHCP is planning to present HCC coding information to all providers in an education session on Friday, March 10 at 7:00 am and again on Thursday, March 23 at 6:00 pm. The session is expected to last about an hour.

If you have HCC coding questions, or would like Sarah Labrec, our outpatient coding specialist, to visit your office for more assistance, please contact Sarah (Sarah.LaBrec@stfranciscare.org), Dr. Ron Kimmel
(RKimmel@stfranciscare.org), or Dr. Sudeep Bansal (SBansal@stfranciscare.org).

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