Health outcomes and service quality-based payment model
ICD10
to HCC Crosswalk
S.No | ICD 10 CM Code | CMS-HCC V24 (Part-C) |
CMS-HCC V28 (Part-C) |
RxHCC
(Part-D) |
Diagnosis Description | Copy |
---|---|---|---|---|---|---|
1 |
Medicare HCC RAF Score REST API
Discover the approach of Population Health Management used to address the unique health risks.
ICD-10:
ICD-10 is an internationally recognized Hierarchical Condition Category Coding system used by healthcare professionals to classify and code all diagnoses, symptoms, and procedures. It serves as a standardized language for healthcare data, facilitating claims processing, medical billing, and patient record-keeping.
HCC (Hierarchical Condition Category):
HCC is a risk-adjustment model developed to estimate future healthcare costs for patients. It categorizes patients into different health statuses based on their diagnoses, providing a way to predict the cost of their care.
How the ICD-10-to-HCC Crosswalk Works?
The ICD-10-to-HCC crosswalk is a crucial tool for healthcare professionals and administrators working within the Medicare Advantage (MA) system. It helps translate specific ICD-10 codes into the corresponding HCC codes, which are used to assess a patient's health status and predict their healthcare costs.
You can simply put the diagnosis codes in the box above and see how this ICD-10-to-HCC Crosswalk works. Up to 10 codes can be added there and it provides you results precisely with a diagnosis description.
Where is the ICD-10 to HCC Crosswalk Useful?
The ICD-10-to-HCC crosswalk is invaluable in several healthcare contexts, especially in Hierarchical Condition Category coding:
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Risk Adjustment: It plays a critical role in risk adjustment models, particularly in Medicare Advantage programs. By converting the specific ICD-10 codes into HCC codes, healthcare providers can more accurately assess the overall health status of MA members, enabling fair and precise reimbursement.
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Healthcare Planning: The crosswalk aids in healthcare planning and resource allocation by allowing organizations to anticipate the healthcare needs of their patient populations.
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Compliance and Reporting: Accurate translation of ICD-10 codes into HCC codes is essential for compliance with regulatory requirements and reporting. The crosswalk ensures that healthcare organizations are correctly categorizing and documenting patient diagnoses.
In short, the ICD-10-to-HCC crosswalk is a pivotal tool in healthcare, helping Professionals Bridge the gap between Hierarchical Condition Category coding and comprehensive health assessments.
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