The Smart Rev Cycle Blog

Medicare Advantage and HCC Coding

Medicare Advantage plans were the first to use HCC for Risk Adjustment in 2004. The way the Risk Adjusted program worked was relatively simple: the Medicare Advantage plan would assume both upside and downside risks for their patient population, and CMS would have a fixed price for these patients....

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Importance of Diagnosis and HCC Coding

Diagnosis Coding is Becoming Increasingly Important Diagnosis coding is becoming more and more important. The shift from volume to value requires HCC coding for patient acuity not just diagnosis coding for medical necessity. During the “Good Old Days” (think pre-Meaningful Use) as well as during...

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Correctly Code Rapid Flu Tests

When it comes to lab tests, one common area of missed revenue occurs with Rapid Flu tests. Doctors can purchase test kits for the Rapid Flu Test (87804) which tests for both A & B strains. Swabs are taken from the patient’s respiratory tract and the claim is coded based on the test results. If...

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