Provider Diagnosis Documentation – Updates to Medicare Risk Adjustment / HCC

January 24, 2024

PROGRAM DESCRIPTION

This presentation reviews the importance of provider diagnosis documentation and ICD-10-CM coding as it relates to Hierarchical Condition Categories (HCC) in CMS Risk Adjustment models. CMS updates to the new V28 Risk Adjustment Model will be discussed and the impact on provider diagnosis documentation and ICD-10-CM code reporting.

Target Audience

Nurses, Nurse Practitioners, Physicians, Physician Assistants, and clinical staff.

Learning Objectives

 
Upon completion of this activity, participants should be able to:
 
  • Demonstrate an understanding of diagnosis documentation and coding importance for Medicare Advantage patients.
  • Build skills of best practice documentation for diagnoses as it relates to notable CMS changes and updates to many ICD-10-CM codes/HCCs in the new risk adjustment model.
  • Improve diagnosing, documenting, and reporting codes with better specificity based on ICD-10-CM classification.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 1.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 1.00 Attendance
Course opens: 
10/31/2023
Course expires: 
02/21/2024
Event starts: 
01/24/2024 - 12:00pm EST
Event ends: 
01/24/2024 - 1:00pm EST
Add to calendar: 
UPMC Health Plan
Pittsburgh, PA 15219
United States

PRESENTER

 
Marlana R. Tice, BA, CCS-P, CPC, CCS, AHIMA-Approved ICD-10-CM/PCS Trainer
Program Director, Risk Adjustment-HCC Coding Education
UPMC Health Plan
 
 

PLANNING COMMITTEE

 
Kalpana Char, MD
AVP, Special Needs Plan Medical Services
UPMC Health Plan
 
Molly Dell, MBA, BSN, RN, CPC
Senior Director, Risk Adjustment Government Rev
UPMC Health Plan
 
 

CONFLICT OF INTEREST DISCLOSURE

No planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.
 

DISCLAIMER STATEMENT

The information presented at this CME program represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine.  Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.
In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC),to provide continuing education for the healthcare team.

Physician (CME)
The University of Pittsburgh designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing (CNE)
The maximum number of hours awarded for this Continuing Nursing Education activity is 1.0 contact hour.

Other health care professionals
Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 1.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 1.00 Attendance
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