Risk Adjustment/Coding Toolkit

Chat Transcript: Coding Work Group 2020, Session 6: MediGold
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.

Presentation: The New Medicare HCC Model V24 (Earn 1 CEU)
As part of the Risk Adjustment & Quality Learning Collaborative, Change Healthcare discusses the new HCC model, version 24, as updated by CMS.

Recording: The New Medicare HCC Model V24 (Earn 1 CEU)
As part of the Risk Adjustment & Quality Learning Collaborative, Change Healthcare discusses the new HCC model, version 24, as updated by CMS.

Recording: Risk Adjustment Round Table 2020, Session 6: Using AWS for Edge Server Submissions
Wesley Sanders, Vice President, Finance and Analytics at Alliant Health Plans shares step-by-step instructions, best practices, and detials on his experience working with the CMS EDGE support team while moving your Edge Server submissions in-house.

Case Studies: Coding Work Group 2020, Session 6 - MediGold
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-1-CM Codes & Guidelines
Change Healthcare team provides the most current (2021) updates regarding ICD-10-CM Official Coding Guidelines for Coding and Reporting FY 2021. Attendees review ICD-10-CM updates from the Centers for Medicare & Medicaid Services (CMS) effective October 1, 2020.

Chat Transcript: Coding Work Group 2020, Session 5: 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.

Recording: Coding Work Group 2020, Session 5: 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.

Recording: Risk Adjustment Round Table 2020, Session 5: Shifting strategies during COVID-19
COVID-19 has completely disrupted our 2020 risk adjustment strategies. How have health plans pivoted? What does your in-home health assessment program look like now? What new things are you trying to ensure you capture a current picture of your members' health for 2020? Join us to share your plan's experience and hear from others.

Case Studies: Coding Work Group October 2020, 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: Coding Work Group 2020, Session 4: CHRISTUS Health Plan
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-Survey Results: Coding Work Group 2020, Session 4: CHRISTUS Health Plan
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.

Chat Transcript: Coding Work Group 2020, Session 4: CHRISTUS Health Plan
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: Coding Work Group 2020, Session 3: Quartz Health Solutions
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.

Chat Transcript: Coding Work Group 2020, Session 3: Quartz Health Solutions
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.

Quartz Health_CodingWorkGroup_July2020
Quartz Health shares recently coded charts and questions to facilitate discussion on risk adjustment coding best practices during the July 9, 2020 Coding Work Group Session.

Recording: Coding Work Group 2020, Session 2: Presbyterian Health Plan
Alliance peers 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.

May 2020 Coding Work Group Case Studies
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.

Screening Questionnaire for Substance DSM-V Criteria
From CHRISTUS Health, the first page is an FYI for the physician and the second page is for the member to fill out (similar to the PHQ9 for MDD). All substance use disorder criteria is the same except for Caffeine and Opioids (as prescribed by a clinician).

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, DSM-5
Before each disorder name, ICD-9-CM codes are provided, followed by ICD-IO-CM codes in parentheses. Blank lines indicate that either the ICD-9-CM or the ICD-IO-CM code is not applicable. For some disorders, the code can be indicated only according to the subtype or specifier.