Coding Education/HCC University

| Training | Helpful Links | FAQs |

CODING & QUALITY KNOWLEDGE COLLEGE

Additional HCC coding courses are available to assist with risk adjustment documentation and coding according to Centers for Medicare & Medicaid Services (CMS) standards and ICD-10 coding requirements. The live sessions will take place the second Wednesday of every quarter from 12:15 p.m. – 12:45 p.m. Each session is eligible for 0.5 AMA PRA Category 1 CME credit. Preregistration for each session is required and an AHN CME account is needed to claim CME credit. Please use the link below to access the quarterly registrations and the instructions below for setting up your CME account with AHN if you don’t already have one.

The information provided is intended to assist with support for the documentation accuracy of the diagnoses codes reported to Highmark and not intended to influence clinical or coding judgment. Information regarding any law or regulation does not constitute legal or tax advice and is subject to change based upon the issuance of new guidance and/or change in laws or regulations. Providers should still reference official ICD-10-CM coding guidelines and manuals or electronic coding software for accurate reporting of compliant diagnosis codes.

• Quarterly Coding & Quality Knowledge College
  Use the link above to register for a session.
• Creating a CME Account
  An AHN CME account is required to claim CME credit for the courses. Instructions for setting up your account are provided in the link above.
• On-Demand Coding Knowledge College Presentations
  Use the link above to find previously recorded sessions.

These presentations are accurate as of the dates they were presented but may change pursuant to regulatory requirements for this program or in response to changing business needs. The contents of these presentations are the property of Highmark Inc., Highmark Health, and/or its subsidiaries (“Highmark”). The information contained in these presentations is confidential and proprietary and is not to be distributed to any outside person(s) or entit(ies) without the express written consent of Highmark.

DISEASE BURDEN CAPTURE VIDEOS

Chronic conditions present challenges, not only from a diagnosis and treatment perspective, but also from a documentation standpoint. Accurate disease burden capture of your patients’ complete health status can increase the quality of care that they receive. To help you and your team fully and precisely document patients’ chronic conditions, Highmark has released a series of brief, informative videos.

Featuring Dr. Frank Colangelo, an internist and primary care physician, the videos provide a list of “dos and don’ts” for achieving accurate disease burden capture.

Videos are available on the following topics:             

• Chronic Conditions – Commonly Missed Diagnoses
• Chronic Kidney Disease (CKD)     
• Congestive Heart Failure (CHF)   
• Chronic Obstructive Pulmonary Disease (COPD)  
• Dementia  
• Diabetes 
• Major Depressive Disorder (MDD) 
• Senile Purpura   
• Vascular Disease 

CLICK HERE to view the videos.

DOCUMENTATION AND CODING REFERENCE CARDS

Listed below are guides to assist with documentation and coding according to CMS documentation standards and ICD-10-CM coding requirements. These are a listing of some of the commonly encountered conditions in the primary care setting but are not an exhaustive list of every condition. Check back regularly as new conditions may be added based on current trends and coding guideline changes.

Amputation

• Amputation Documentation Reference Card
• Amputation Coding Reference Card

Angina

• Angina Documentation Reference Card
• Angina Coding Reference Card

Arrhythmia

• Arrhythmia Documentation Reference Card
• Arrhythmia Coding Reference Card

Arthritis

• Arthritis Documentation Reference Card
• Arthritis Coding Reference Card

Artificial Openings (Ostomies)

• Artificial Openings Documentation Reference Card
• Artificial Openings Coding Reference Card

Asthma

• Asthma Documentation Reference Card
• Asthma Coding Reference Card

Atherosclerosis

• Atherosclerotic Heart Disease Documentation Reference Card
• Atherosclerosis of Extremities Documentation Reference Card
• Atherosclerosis Coding Reference Card Autologous Nonautologous Graft
• Atherosclerosis of Extremities Coding Reference Card - Part 1
• Atherosclerosis of Extremities Coding Reference Card - Part 2
• Atherosclerosis of Extremities Coding Reference Card - Part 3

Autoimmune Disorders

• Autoimmune Documentation Reference Card
• Autoimmune Coding Reference Card

Behavioral Disorders

• Behavioral Disorders Documentation Reference Card
• Behavioral Disorders Coding Reference Card

Cancer

• Cancer Documentation Reference Card
• Cancer Coding Reference Card

CHF

• CHF Documentation Reference Card
• CHF Coding Reference Card

Coagulopathy

• Coagulopathy Documentation Reference Card
• Coagulopathy Coding Reference Card

COPD

• COPD Documentation Reference Card
• COPD Coding Reference Card

CVA

• CVA Documentation Reference Card
• CVA Coding Reference Card - Active
• CVA Coding Reference Card - Sequela

Dementia

• Dementia Documentation Reference Card
• Dementia In Other Diseases Classified Elsewhere Coding Reference Card
• Unspecified Dementia Coding Reference Card
• Vascular Dementia Coding Reference Card

Diabetes

• Diabetes Documentation Reference Card
• Diabetes Complications Documentation Reference Card
• Diabetes Type 1 Coding Reference Card
• Diabetes Type 2 Coding Reference Card

Embolism/Thrombosis/Phlebitis

• Embolism/Thrombosis Documentation Reference Card
• Embolism Lower Extremity ACUTE Coding Reference Card
• Embolism Lower Extremity CHRONIC Coding Reference Card
• Embolism/Thrombosis Lower Extremity Coding Reference Card
• Embolism/Thrombosis Torso Upper Extremity Coding Reference Card
• Phlebitis/Thrombophlebitis Coding Reference Card

Epilepsy/Seizures

• Epilepsy/Seizure Disorder Documentation Reference Card
• Epilepsy/Seizure Disorder Coding Reference Card

Hemolytic and Hemorrhagic Disorders

• Hemolytic and Hemorrhagic Documentation Reference Card
• Hemolytic and Hemorrhagic Coding Reference Card

Hepatitis

• Hepatitis Documentation Reference Card
• Hepatitis Coding Reference Card

Immunodeficiency

• Immunodeficiency Documentation Reference Card
• Immunodeficiency Coding Reference Card - Part 1
• Immunodeficiency Coding Reference Card - Part 2

Kidney Disease

• Kidney Disease Documentation Reference Card
• Kidney Disease Coding Reference Card

Major Depressive Disorder (MDD)

• MDD Documentation Reference Card
• MDD Coding Reference Card

Malnutrition

• Malnutrition Documentation Reference Card
• Malnutrition Coding Reference Card

Morbid Obesity

• BMI and Morbid Obesity Documentation Reference Card
• BMI and Morbid Obesity Coding Reference Card

Movement & Neuro Disorders

• Movement & Neuro Disorders Documentation Reference Card
• Movement & Neuro Disorders Coding Reference Card

Myocardial Infarction (MI)

• Myocardial Infarction Documentation Reference Card
• Myocardial Infarction Coding Reference Card

Peripheral Vascular Disease (PVD)

• PVD Documentation Reference Card
• PVD Coding Reference Card

Pressure Ulcers

• Pressure Ulcers Documentation Reference Card
• Pressure Ulcers Coding Reference Card

Social Determinants of Health

• SDOH Coding Reference Card 1
• SDOH Coding Reference Card 2

Substance Use Disorders

• Substance Use Disorders Documentation Reference Card
• Substance Use Disorders Alcohol Coding Reference Card
• Substance Use Disorders Coding Reference Card

TRAINING PRESENTATIONS AND RESOURCES

Listed below are resource presentations to provide guidance on risk adjustment in clinical practice. 

• 2024 Risk Adjustment Overview (Video)
• Risk Adjustment Overview
• HCC Model V28 Documentation Considerations (Video)
• Annual Wellness Visit and Risk Adjustment

If you experience an issue with the video links above, please refresh your browser. If the issue persists, contact resourcecenter@email.highmark.com.

HELPFUL LINKS

Please see the links below to CMS and other coding resources.

• AAPC
• AHIMA
• 2022-ICD-10-CM
• MLN Web Based Training
• CMS Guide for AWV
• CMS Updated Coding Guidelines for COVID-19

CODING QUESTIONS

If you have questions about risk adjustment documentation and coding, please send an email to RiskAdjustmentCoding@Highmark.com to be answered by our coding team.

Please note that answers will be provided based on current CMS and coding regulations and will not direct clinical care. Please do not send any emails containing PHI.