I understand HCCs and risk adjustment but I have two questions that I can't get clear answers from researching the topic:
1) Do HCCs only apply to Medicare Advantage and 2) How does capturing HCCs affect hospital payment.
Julie Geiger BS, RN, CCDS
Operational Lead Clinical
11109 Parkview Plaza Drive
Fort Wayne, IN 46845
I have a question regarding HCC 58: MDD, Bipolar & Paranoid disorders.
I am currently working with outpatient Physician practices for Risk Adjustment Documentation, and several physicians refuse to document or diagnose "Major Depressive Disorder" even if the patient meets the depression screening (PHQ 2/PHQ9) and is on active antidepressant. Diagnoses like "insomnia, anxiety disorder" becomes the diagnosis .
I've been told that "MDD diagnosis gets denied" and is not "accepted by their Billing vendor", because "only psychiatrists can diagnose MDD"
I do not agree with the above statement, and is there an official guideline that I can refer to and present to the outpatient Family Practice physicians?
Thanks, Martha Padolina RN CCDS