Risk Adjustment Documentation and Coding Boot Camp Online

Risk Adjustment Documentation and Coding Boot Camp Online

Course Overview

Risk score training beneficial for both Coding and CDI professionals

Risk adjustment requires coding and CDI professionals to work together as one team to ensure the capture of the most appropriate risk score for each patient.

If you're looking for ways to expand your CDI department into outpatient settings and services—all of which can impact risk scores—you'll find it in the Risk Adjustment Documentation and Coding Boot Camp Online.

The Risk Adjustment Documentation and Coding Boot Camp Online not only addresses compliant coding practices, but also the reporting requirements related to valid risk adjustment scoring.

This course applies the core concepts of Clinical Documentation Integrity related to record review and provider education, allowing both coding professionals and CDI specialists to accurately capture a patient's complexity and accurate risk scoring.

The process of risk adjustment accounts for known health conditions, allowing for comparison of wellness amongst patients. Most risk adjustment models utilize diagnosis codes to determine potential risks. The variables pulled from documentation can assist in identification of those patients with a higher medical need than others. The process of risk adjustment is used to predict both costs and allow for comparisons related to quality-of-care measures.

This course reviews various risk adjustment methodologies with a deep focus upon CMS Hierarchical Condition Categories. A review of risk score calculation and those diagnoses/conditions that offer impact will assist your efforts and success is risk adjustment reporting.

This boot camp will help you:

• Gain a detailed understanding of risk adjustment and identify diagnoses and conditions that affect risk scores
• Utilize the Official Guidelines for Coding and Reporting to assign codes
• Recognize a reportable diagnosis and identify elements to support code assignment
• Assist providers in strong documentation in support of successful audit results

Leave this boot camp with an understanding of:

• Risk adjustment's role in reimbursement and CMS's quality measures
• CMS HCC and risk adjustment scoring
• The correct codes for common diagnoses that affect risk scores
• Strong documentation in support of RADV audits
• Documentation requirements to support accurate risk score capture

ACDIS, NAHRI, or AHIMA members save $100 off the registration fee. Call 800-650-6787 to receive your special discount rate or to become a member!

Benefits of program & features:

• Structure: Each module in the library is interactive, with voice-over narration, and includes "Test Your Knowledge" questions throughout to reinforce major concepts. Upon completion of all modules, participants will be required to complete a 40-question final exam in order to receive completion certificates and CEUs.
• Ask the Expert: You can also email questions to our instructors. We try to answer all questions either via email or phone within two business days.
• 60-day access to instruction after purchase: You have 60 days to work through all modules and complete assignments.
• 24-hour access: Instruction is available at any time of day—you choose the time that works for you.
• Expertly designed course materials: Course materials are developed by an adult education expert. The curriculum uses a "how to" approach where participants learn how to apply concepts that they can then customize to their organizational needs. Content is regularly updated based on changing industry practices and participant feedback.
• Well-established program: Brought to you by the Association of Clinical Documentation Integrity Specialists (ACDIS), this Boot Camp from the industry's only dedicated CDI association provides the best-in-class education you expect.

Contact sales:
For more detailed information, contact us at 800-650-6787 or email sales@hcpro.com.

80+ started a course from this library within All-Access: Coding

Risk Adjustment Documentation and Coding Boot Camp Online

Who Should Attend

• Professional coders
• CDI specialists
• HIM and CDI directors and managers
• Providers
• Physician practice managers
• Revenue cycle staff
• Professionals in the payer setting who administer risk-adjusted plans

Risk adjustment concepts from the course can also be applied by professionals who monitor quality measures related to the Hospital Value-Based Purchasing (HVBP) Program and the Physician Quality Reporting System (PQRS).

This Boot Camp does not lead to formal ACDIS or AHIMA certification.

Risk Adjustment Documentation and Coding Boot Camp Online

Course Content

• Module 1: CMS Reimbursement: IPPS, OPPS, and Medicare Advantage Quality Incentives
• Summary of Medicare Parts A–D
• Inpatient Prospective Payment System (IPPS)
• Outpatient Prospective Payment System (OPPS)
• Medicare Advantage Plans
• Prescription Drug Coverage
• Module 2: ICD-10-CM Diagnosis Coding: Documentation Sources, Diagnosis Selection, and Official Guidelines
• Sources of Authority for ICD-10-CM Coding
• Documentation Sources
• Diagnosis Coding—Inpatient Services
• Diagnosis Coding—Outpatient/Professional Services
• Uncertain Diagnoses
• Signs/Symptoms
• Comparative/Contrasting Diagnoses
• Acute and Chronic Conditions
• Combination Codes
• ICD-10-CM Conventions
• Excludes notes
• Laterality
• Module 3: Introduction to Risk Adjustment: Review of Risk Adjustment Methodologies
• Risk Adjustment Models
• HHS-HCCs
• Adjusted Clinical Groups
• CDPS
• DRGs
• CMS-HCCs
• Demographic Variables
• Hierarchical Condition Categories
• Applicable settings
• Approved providers
• Medicare Advantage Plans
• Prescription Drug Coverage
• Module 4: Hierarchical Condition Categories and the Hierarchies
• Review of Key Diagnoses From Each HCC
• Module 5: Disease Interactions and Disabled Disease Interactions
• Roles of Disease Interactions in Risk Adjustment
• Module 6: Risk Adjustment Validation: RADV Audits

*Agenda subject to change.

Duration: 418 minutes

This course requires the following pre-requisites:

• The course is intended as an introduction to risk adjustment methodologies and the application of coding and CDI practices to capture accurate risk adjustment. It is highly recommended that attendees have existing knowledge of basic diagnosis code assignment as well as basic principles of CDI. This course is not intended to teach coding or basic CDI principles.

This course requires the following materials:

• There are no required materials for this Boot Camp.

Risk Adjustment Documentation and Coding Boot Camp Online

Synopsis

The Risk Adjustment Documentation and Coding Boot Camp® Online goes beyond just knowing how to code for a condition. It explores where to obtain coding information as well as where to look for documentation deficiencies to improve overall risk scores.

Learning Objectives

Upon completion of this module, participants will be able to:

• Discuss predictive modeling and the concept of risk adjustment
• Explain how risk adjustment is applied to reimbursement in healthcare
• Explain how risk adjustment is applied to CMS quality measures
• Identify the different models used in risk adjustment
• Discuss the process of computing the Risk Adjustment Factor (RAF) score for individuals
• Describe the process of Risk Adjustment Data Validation (RADV) audits
• Identify elements within a medical record that can be used to support code assignment
• Define what is considered a reportable diagnosis
• Identify the most common conditions found within the Hierarchical Condition Categories (HCC) risk adjustment methodology
• Apply the Official Guidelines for Coding and Reporting when assigning codes to these common conditions
• Identify query opportunities related to documentation deficiencies that would likely impact HCC assignment and RAF score
• Apply the process of record review for HCC risk adjustment to clinical examples

Continuing Education

The following types of Continuing Education are offered only after the completion of all courses and the successful completion (80% pass rate) of the final exam. Upon achieving a passing exam score, users will be directed to a course evaluation that will open in a separate window which will need to be completed and submitted for both instant download and email delivery of all applicable CE certificates.

AAPC
This program has the prior approval of AAPC for 6.5 continuing education unit(s) CEUs). Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

ACCME
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 7 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACDIS
This program has been approved for 7 continuing education unit(s) towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

AHIMA
This program has been approved for 7 continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Disclosure Statement

Please note the planners, presenter(s), and contributors to this activity have disclosed no relevant financial relationships with any commercial companies pertaining to this activity.

Risk Adjustment Documentation and Coding Boot Camp Online

Faculty

Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, is an experienced CDI subject matter expert, former interim ACDIS director, and former CDI education director at HCPro. While at ACDIS and HCPro, she was also the lead developer and instructor for the CDI Boot Camps as well as a member of the CCDS-O certification committee and the ACDIS Advisory Board; she also frequently spoke on the ACDIS Podcast and at ACDIS conferences and webinars. She is the author of The Clinical Documentation Improvement Specialist's Complete Training Guide and the ACDIS Pocket Guide series. Prescott has served in a variety of health systems and settings since joining the nursing profession in 1985 and she developed and implemented a CDI program in 2007.

Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, CCDS-O, is the director of HIM and coding for HCPro. She oversees all of the Certified Coder Boot Camp programs. In addition, she specializes in creating custom designed educational programs for Propel Coding membership clients. McCall was one of the original ACDIS Advisory Board members and one of the contributors to the development of the CCDS-O certification examination.

Risk Adjustment Documentation and Coding Boot Camp Online

Preview This Course

Explore a sample of this course below. The interactive preview is available for 10 minutes.

Risk Adjustment Documentation and Coding Boot Camp Online

Frequently Asked Questions

See Course Content tab for course description and total duration.

1. How long will the online content remain accessible after class ends?

   The online portal location for your class sessions and materials will be available for 60 days from the purchase date.

   You must complete the course evaluation in order to get your continuing education/contact hour certificate, so please be sure to complete the course before your access expires.
   
   

2. Does this education lead to a formal AHIMA or ACDIS certification?

   No, this education does not lead to a formal AHIMA or ACDIS certification.
   
   

3. Is there a discount for ACDIS, NAHRI, or AHIMA members?

   Yes, ACDIS, NAHRI, or AHIMA members receive $100 off the registration fee. Contact us at 800-650-6787 or email sales@hcpro.com.
   
   

4. How does it work?

   You'll receive the same content and instruction that you would experience at our classroom-based, nationally recognized boot camps. Here's how it works:

   • 60-day access from your purchase date: View sessions, ensure understanding with questions that test your knowledge, and complete the final exam to obtain CEU credits.
   • 24-hour access: Modules are available at any time of day—you choose the time that works for you.
   • Ask the Expert: Email questions to our instructors. We try to answer all questions either via email or phone within two business days.
     
     

5. Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?

   Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."
   
   

6. Does HCPro offer this boot camp as an on-site course?

   In addition to our open registration courses, we also offer the boot camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site, call 800-780-0584 or click on "Train Groups On-Site."
   
   

7. What if I need to cancel or transfer my registration?

   Please click here to view our cancellation policy.
   
   

8. How do I get more information?

   Contact us at 800-650-6787 or email sales@hcpro.com.
   
   

Dates

Below is the current course schedule for upcoming CDI and Quality Care Measures Boot Camp Online classes.

To view our cancellation policy, click here.