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Risk Adjustment

$1,850.00

This online course teaches fundamental medical coding skills for risk adjustment coding and prepares the student to take AAPC’s CRC exam. Students are given access for twelve months from the date of purchase.

The course is designed to be completed in 3 months, however OS2U allows for an additional 9 month grace period, giving you a full 12 months access from date of purchase. Apart from reading & study time, this course includes approximately 40 clock hours of contact work.

The course covers ICD-10-CM coding for all risk adjustment models (HCC, HHS-ACA, CDPS). Assures a broad knowledge in reviewing and assigning the correct diagnosis codes for all risk adjustment models.

Supplies Necessary for Program:

  • AAPC Membership
  • CRC Workbook
  • Current Year ICD-10 CM
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Description

This online course teaches fundamental medical coding skills for risk adjustment coding and prepares the student to take AAPC’s CRC exam. Students are given access for twelve months from the date of purchase.

Students will learn principles of risk adjustment and accurate diagnosis coding. In addition, there will be discussion of predictive modeling, financial impact of risk adjustment coding, documentation challenges, official diagnosis coding guidelines, and diagnosis coding in ICD-10-CM. This course is recommended for anyone who is currently working in risk adjustment or wants to learn risk adjustment coding.

Supplies Necessary for Program:

  • AAPC Membership
  • CRC Workbook
  • Current Year ICD-10 CM

Additional information

Date

November 1, 2021, November 7, 2022

Additional information

Course Objectives:

  • Define different models of risk adjustment (HCC, CDPS, Hybrid)
  • Understand predictive modeling and its impact on risk adjustment
  • Explain risk adjustment impact on financial matters
  • Apply official coding guidelines
  • Identify elements of the medical record
  • Identify documentation deficiencies for diagnosis coding
  • Understand the most common conditions in risk adjustment and how to properly code in ICD-9-CM and ICD-10-CM

 

Course Content: (Lecture 20 hours. Lab 10 hour)

  • Risk Adjustment Models (Lecture 2 hours. Lab 0 hour)
    • Hierarchal Condition Categories (HCC)
    • Medicaid Chronic Illness and Disability Payment System (CDPS)
    • Hybrid models
  • Predictive Modeling & Quality of Care (Lecture 2 hours. Lab 0 hour)
    • Predictive modeling impact
    • Suspect logic
    • Quality of care
    • Star ratings
  • Risk Adjustment and Financial Matters (Lecture 2 hours. Lab 0 hour)
    • HCC RAF score
    • Financial impact based on coding
  • Diagnosis Documentation and Coding (Lecture 1 hours. Lab 0 hour)
  • Common errors in diagnosis coding (Lecture 1 hours. Lab 0 hour)
  • Elements of the medical record (Lecture 1 hours. Lab 0 hour)
  • Documentation Barriers (Lecture 2 hours. Lab 2 hour)
  • Signatures
  • Insufficient documentation
  • Risk Adjustment Data Validation (RADV) process
  • Official diagnosis coding guidelines
  • Frequently coded conditions (using ICD-9-CM and ICD-10-CM) (Lecture 8 hours. Lab 5 hour)
    • Acute vs. Chronic conditions
    • Differential Diagnosis
    • Risk Factors and Comorbidities
    • Angina
    • Artificial Openings
    • BMI and Obesity
    • Cardiac Conduction Disorders
    • Cardiomyopathy
    • CVA
    • CKD, Dialysis, and AV Fistula
    • COPD
    • Complications of Care
    • Congestive Heart Failure
    • Cardio Pulmonary
    • DVT
    • Dementia
    • Depression
    • Diabetes and Secondary Diabetes
    • Epilepsy & Convulsions
    • GERD
    • Hepatitis & Cirrhosis
    • HIV
    • Hypercholesterolemia
    • Hypertension
    • Hypothyroidism
    • Klebsiella Pneumoniae
    • Malnutrition & Cachexia
    • Myocardial Infraction
    • Neoplasms
    • Neuropathy
    • Pneumonia
    • Pulmonary Embolism
    • Pulmonary Hypertension
    • Respirator/Ventilator Status
    • Septicemia & Sepsis
    • Ulcers & Wounds
    • Varicose Veins
    • Vertebral Fractures
  • Practical Expertise (Lecture 1 hours. Lab 3 hour)
    • Practical diagnosis coding skills utilizing cases for practical application

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