Hierarchical Coding Categories (HCC) is becoming a common term as healthcare continues to move toward an “outcomes” based model. Understanding the acronym T.O.A.D is of utmost importance.
There are ‘status’ conditions within the HCC model that do not require documentation of being monitored, evaluated, assessed, or treated (M.E.A.T.) during a patient encounter for the conditions to be coded. Capturing these conditions are often missed or completely omitted. Documentation can be found in the Past Medical History, Past Surgical History, HPI, Assessment/Plan, etc. -- These conditions are considered HCCs and can impact physician reimbursement. Per Anthem, ‘status’ conditions must be reported annually to be included in the risk score. T.O.A.D., Transplants, Ostomies, Amputations, Dialysis - When coding, don’t forget the T.O.A.D.
Providing coders with resources to ensure knowledge of up-to-date and accurate coding information supports an efficient, effective revenue cycle. Axea offers customized coding education, skills testing and evaluation through Axea Academy™ for coding teams, candidates and newly hired coders. LEARN MORE about educating your coders.
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