HCC Coding for Providers: Status Conditions

Submitted by Dr. Barbara Fenton, MD, FACP, Medical Director of Augusta Care Partners and D. Scott Jones, CHC, Compliance Officer

In response to the feedback we’ve received from our Provider HCC Risk Adjustment CME, we’ve prepared a few specific coding tips that you can immediately put into practice. We definitely want to keep the momentum going, so please keep your suggestions coming.

The following are status conditions that must be documented and coded at least once during the calendar year.

  1. Any amputation status
  2. Any artificial opening status, e.g. tracheostomy, gastrostomy, ileostomy, colostomy, cystostomy, ureterostomy, urethrostomy
  3. Any tissue or organ transplant status
  4. Renal dialysis status, and non-compliance with renal dialysis (when present)
  5. Hemiplegia, diplegia, or paraplegia
  6. Morbid obesity; Note: you will need to enter E66.01 AND the specific BMI code: Z68.4X. (For morbid obesity with alveolar hypoventilation use E66.2)

We have also added additional sessions of the HCC Coding for Providers CME program. If you were unable to attend any of the previous programs, you now have three more opportunities to meet this Tier 1 incentive requirement:

  • April 26 @ 5:30pm in ACC 3
  • May 30 @ 5:30pm in the Mannix Conference Room (H&V Center)
  • June 20 @ 5:30pm in the Mannix Conference Room (H&V Center)