Austin, Texas – October 25, 2016 – Caravan Health is hosting a webinar on November 1st at 11am Pacific / 2pm Eastern to walk through Hierarchical Condition Categories (HCC) codes and how to document them appropriately so that your practice will receive appropriate payment under Comprehensive Primary Care Plus (CPC+). Click here to register for and log into this webinar using event number 661 210 955 and password HCC101.
Starting in 2017, physicians participating in the CPC+ program will receive care management fees based on diagnostic codes for chronic conditions, including dementia, submitted with claims during the prior calendar year. Each patient will be assigned a risk factor based on age, gender, disability and chronic conditions. These scores will be used to determine the amount paid to CPC+ practices in care management fees. Failure to submit claims data listing specific and accurate diagnosis codes representing all of your patients’ chronic conditions by December 31, 2016 may result in underpayment of the CPC+ care management fees.
In addition, Track 2 CPC+ practices will be paid $100 per patient per month in Care Management Fees for their dementia patients, many of whom will require extra support and time with the practice. Unfortunately, this diagnosis is not always submitted with claims every year. According to the 2005 Aging, Demographics, and Memory Study published in the Journal of Neuroepidemiology, prevalence of dementia among individuals aged 71 and older was 13.9%, comprising about 3.4 million individuals in the USA in 2002. Dementia prevalence increased with age, from 5.0% of those aged 71-79 years to 37.4% of those aged 90 and older.
Today, Caravan Health supports 23 ACO’s comprised of hundreds of hospitals and clinics. An internal review of the claims data from more than 700,000 Medicare patients in these ACO’s indicates that 40% of appropriate diagnosis codes are missing. The CMS risk adjustment program requires thorough documentation of each of these diagnoses each year. According to the ICD-10 manual, providers must “Code all documented conditions which coexist at the time of the visit that require or affect patient care or treatment.” Chronic conditions that are not documented annually are assumed to have been resolved or are no longer affecting patient treatment. In CPC+, this will result in a reduction of Care Management Fees.
Join us on November 1 at 11am Pacific / 2pm Eastern online at http://bit.ly/2f590F1 to learn more about how accurate reporting of HCC codes in 2016 can help CPC+ practices accurately describe the severity of their patient population, and ensure proper compensation.