Risk Adjustment/Coding Toolkit

Recording: Risk Adjustment Roundtable May 2022
Connect with your Alliance risk adjustment peers to discuss your top challenges, share your expertise and build your network.

Recording: Coding Work Group: April 2022
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinic 2016 - Behavioral and Neurodevelopmental Disorders
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinic 2020 - Partial Glasgow Coma Score
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinic 2019- Crohns Disease
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinic 2020 - Coding Mental Conditions as Additional DX's
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinic 2021 - Hypercoaguable State
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinic 2021-Reporting Additional Diagnoses
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

2021 ICD 10CM Official Guidelines for Coding Reporting
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Coding Clinics
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

HRADV 2020 Benefit Year Protocols
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices. The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

April 2022 Coding Work Group Case Studies
*UPDATED April 13, 2022* Health Alliance Medical Plans shares recently coded charts and questions to facilitate discussion on risk adjustment coding best practices during the April 21, 2022 Coding Work Group Session.

Recording: Coding Chronic Conditions Roundtable Call
There appear to be different interpretations of the Coding Guidelines that govern the capturing and billing chronic conditions during an annual exam or annual wellness exam. This call is being scheduled as a follow-up to the February 16, 2022 discussion forum post to continue the conversation: https://www.healthplanalliance.org/DiscussionForums/DiscussionDetail.asp?threadid=11302

MediGold Risk Adjustment Job Descriptions
Shared at the Risk Adjustment Fly-In, February 8-9, 2022.

MediGold Risk Adjustment Org Chart
Shared at the Risk Adjustment Fly-In, February 8-9, 2022.

Recording: Coding Work Group 2021, Session 6: Health New England
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. Remaining time is used for open discussion.

Pre-Work Packet: Coding Work Group 2021, Session 6: Health New England
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.

Recording: Changes to ICD-10-CM Codes and Guidelines Effective 10-1-2021
Review the most current updates regarding ICD-10-CM Official Coding Guidelines for Coding and Reporting FY 2022 that go into effect on Oct. 1, 2021.

Presentation: Changes to ICD-10-CM Codes and Guidelines Effective 10-1-2021
Review the most current updates regarding ICD-10-CM Official Coding Guidelines for Coding and Reporting FY 2022 that go into effect on Oct. 1, 2021.

Recording: Coding Work Group 2021, Session 5: SelectHealth
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.