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November 2024

Do you have time for a Quality Minute about HCC coding persistency?

This is another article in an ongoing series of quick tips designed to be read in 60 seconds or less, and provide your practice with information about performance in key areas.

Hierarchical condition category, or HCC, coding persistency

  • Persistency is the recapture of chronic diagnoses year over year for risk adjustment purposes.
  • Blue Cross Blue Shield of Michigan sends an HCC coding list to Edifecs mailboxes on the first Thursday of every month that can be used to identify possible diagnoses for risk capture.
  • Pre-visit chart prep is a key strategy to recapturing chronic disease codes. This includes reviewing the medical record for current or past chronic conditions, problem list, and consultations and discharge summaries for potential new conditions.
  • Providers should code all documented conditions that coexist at the time of the visit and that require or affect patient care, treatment and management.
  • It’s important to ensure you capture your patients’ complete and accurate full burden of illness.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2023 American Medical Association. All rights reserved.