Hierarchical Condition Category (HCC)/Risk-Adjustment Coding and Audit Services

Examples may include:

• Health record does not have a legible signature with credentials or not authenticated and electronically signed.

• Highest degree of specificity was not assigned to diagnosis.

• A discrepancy exists between billed diagnosis and actual description of the condition noted in documentation.

• Documentation does not indicate a condition as being Monitored, Evaluated, Assessed, or Treated (MEAT).

• Chronic conditions and status codes are not documented on an annual basis.