Let’s face it, risk season is chaotic. From July to December, sometimes even into January, everyone is scrambling to find quality coders with the unique qualifications needed to effectively code for risk adjustment (RA) and hierarchical condition categories (HCC). If you are lucky enough to find coders, you still have the stress of looming deadlines you must meet. And of course, because revenue is at risk, you want to ensure that your coding quality doesn’t slip.
The landscape of physician coding changed dramatically in 2015 with the implementation of ICD-10 and MACRA. This coupled with the continued trend of health systems acquiring physican practices has put a greater emphasis on coding of professional services. These factors have contributed to many organizations choosing to integrate phyisican coding into their HIM department.
With 60% of the Merit-Based Incentive System (MIPS) score for providers coming from risk adjusted quality and resource use scores, it is critically important to accurately reflect the acuity of your patient population. Doing so will allow your quality and cost scores to accurately reflect the care provided by your physicians.