Accurate diagnosis coding, which contributes to a more complete picture of patient health status, may have a positive effect on your payment in the future as more payers move to risk-adjusted payment models. Adopting these five coding habits will position your practice for success:
1. Use the problem list feature in your electronic health record to track relevant diagnoses.
2. Report not only the diagnosis codes that describe why a patient was seen but also any diagnosis codes associated with chronic conditions that affected treatment choices.
3. Code to the highest level of specificity.
4. Code comprehensively at annual visits, because patient risk scores are reset each year.
5. Select diagnosis codes that map to Hierarchical Condition Categories (HCCs). A cheat sheet can help. See “ICD-10 – HCC Coding Reference for Family Medicine.”
Adapted from “Is Your Diagnosis Coding Ready for Risk Adjustment?” and “Diagnosis Coding for Value-Based Payment: A Quick Reference Tool.”
Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights," featuring practical, peer-reviewed advice for improving practice, enhancing the patient experience, and developing a rewarding career.
Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.