Quality & HCC Coding Tips

JOY, JOY, JOY! For the month of December, we have just two Quality metrics to highlight…and a reminder about HCCs of course.

“Tobacco Use Screening” requires cessation counselling for those who screen positive. This measure includes any form of tobacco use. When a patient uses smokeless tobacco, remember to provide education – advising them to quit or providing patient educational material on tobacco cessation is considered adequate documentation. Also, since it IS the season, remember to ask about “Influenza Immunization” and be sure to document it if the patient declines, received it elsewhere, has an allergy, or the vaccine is not available at your office. Any of these qualify to pass the measure.

Thank you for helping us report the best quality we can for you – those extra EMR clicks to make it happen do not go unnoticed!

Also, a BIG THANKS to everyone who’s participated in the HCC & Coding education and documentation improvement initiative this year.

We have already seen significant improvement in our network’s coding of Diabetes With Complications versus Diabetes Without Complications! If you’re at AMG and using Athena, please don’t forget the HCC Fly-Out. Our off-site coder is reviewing your records and surfacing potential diagnoses that have not been coded this year. These may be diagnoses that you are unaware of, or forgot to code. After reviewing the fly-out, you can decide to accept or dismiss the diagnosis.

Remember, all chronic conditions must be coded within the year, to accurately reflect your patient’s complexity and total HCC score. Otherwise, CMS sees the patient as a “Miracle Cure”.

In 2019 we plan to continue coding support, along with immediate provider feedback (keep an eye out for Janell Sauder’s emails).

To all of you and to your families, our warmest wishes for a safe and happy holiday season!

ACP Operations & Quality Team