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Coding Corner
The federal government reimburses Medicare Advantage plans based on the documented health of their members through a method used by CMS called "Risk Adjustment." This reimbursement is based on the anticipated cost of members' healthcare and is what health plans rely on to accurately estimate healthcare costs and provide high-quality affordable Medicare Advantage products.
Providers play an important role in the risk adjustment process. Medical record documentation and claims coding data are used to help indicate the complete picture of health for plan members. This data also enables Blue Advantage to analyze and design programs to help manage member care.
Documentation and coding must mirror one another in order to accurately capture the patient's complete picture of health. Use our resources below to provide the most accurate, complete coding and documentation possible.
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Documentation and Coding Tips
- Common HCC ICD-10 Codes
- ICD-10 Data
- Documentation and Coding by Condition:
- Aneurysms
- Atherosclerosis
- Cancer
- Carotid Artery Disease
- Cerebral Infarction, Transient Ischemic Attack and Sequela
- Congestive Heart Failure
- Chronic Lower Respiratory Diseases
- Deep Vein Thrombosis (DVT)
- Depression
- Diabetes
- Documentation and Coding Guidance
- Hypertensive Chronic Kidney Disease
- Hypertensive Heart Disease
- Hypertensive Heart and Chronic Kidney Disease
- Weight Related Diagnoses
Risk Webcasts
Strategies for Improving Medication Adherence
May 2022
Rheumatoid Arthritis
December 2021
COPD
December 2021
Vascular Disease Part 2
December 2021
Cancer
December 2021
Diabetes
July 2021
Vascular Disease
July 2021
Depression
July 2021
Heart Failure
July 2021
Clinical Review of Medicare Advantage Risk Adjustment and Chronic Condition Coding
September 2020