The CMS HCC coding list is the correct tool for coders to verify if a diagnosis falls under Hierarchical Condition Categories (HCC). This list specifically outlines all the diagnoses that are recognized for risk adjustment by Medicare and is essential for accurate coding and compliance purposes. It categorizes diagnoses that reflect the severity of patient conditions and allows for adequate risk adjustment in reimbursement.
Using the CMS HCC coding list, coders can determine which conditions are eligible for HCC selection, ensuring they properly capture the health status of patients. This is crucial for maximizing risk-adjusted payments and ensuring that healthcare providers receive appropriate compensation based on the complexity and resource requirements of patient care.
While other resources, such as the ICD-10-CM coding manual or the AMA guidelines, provide vital information regarding general coding and best practices, they do not specifically focus on the nuances of HCC coding and risk adjustment as the CMS HCC coding list does. The National Provider Identifier Database is primarily concerned with the identification of healthcare providers rather than diseases or diagnostic criteria.