What is an HCC?

HCC coders are health information professionals who specialize in Hierarchical Condition Category (HCC) coding. They review medical records to identify and assign diagnosis codes that reflect the severity and complexity of a patient's health conditions. This coding is essential for risk adjustment in Medicare Advantage and other value-based care programs, impacting reimbursement and quality measurement. HCC coders must be familiar with ICD-10-CM coding guidelines, clinical documentation, and risk adjustment models to ensure accurate and compliant coding.