Posted and filed under Coding, Medical Record Auditing.

If you’re reading this article, chances are you already know what HCC Coding is – but we’ll give you a refresher anyway. Hierarchical Condition Category (HCC) and Risk Adjustment Coding is a CMS-mandated payment model. This particular model works to identify those with chronic and other serious illnesses and prescribes a risk factor score to each patient, taking into consideration their ailments and other demographics.

With every payment model comes a specific set of audit and review requirements that must be met in order to maintain the integrity of the system, and this is where MEAT (Monitor, Evaluate, Assess/Address, Treat) comes in handy.

In a face to face visit M.E.A.T. maybe found in the chief complaint, history of present illness, review of systems, physical exam, assessment and/or plan.

  • Monitor – Ex. If there are there signs/symptoms for COPD, the provider may mention wheezing. For Parkinson’s disease, the provider may mention that the patient’s tremors have increased or decreased.
  • Evaluate – Ex.  For diabetes, you may see the results of an A1C test, or for Chronic Kidney Disease Stage 4; you may see the results for a GFR. The provider may document a cancer patient’s response to chemo or radiation.
  • Assess/Address – Ex.  Provider may provide counseling for diet/exercise for a patient diagnosed with morbid obesity (with a BMI of 40+).  The provider may mention that they are reviewing records from a specialist.
  • Treat – Ex. The provider may link the medication to a patient’s diagnosis to a particular medication, for example: “pt. is currently taking insulin for their diabetes”. Therapy is another treatment option, where a provider may note that a patient with major depression is receiving psychotherapy.

 

meat hcc coding