Cosa significa sospetto HCC?

Cosa significa sospetto HCC?

È il principale tumore maligno del fegato. I termini carcinoma epatocellulare, epatocarcinoma e tumore maligno primitivo del fegato sono tutti sinonimi. Il termine epatoma è invece un termine poco usato e non corretto. L'abbreviazione più comune è HCC che deriva dalla terminologia inglese (Hepato Cellular Carcinoma).

What is an HCC and how does it work?

• CMS uses HCCs to reimburse Medicare Advantage plans based on the health of their members. It pays accurately for the predicted cost expenditures of patients by adjusting those payments based on demographic information and patient health status.

What are hierarchical condition categories (HCC)?

• Except there is this: Hierarchical Condition Categories (HCC), a risk adjustment model that has been around for years but has heightened visibility since Medicare Advantage Plans started to require RAF scores for reimbursement. Today it’s on the radar of every coding leader, and every commercial payer, for that matter.

What is CMS-HCC and how does it affect you?

• This new model is called CMS-HCC and is based on serious or chronic health conditions. Physicians must thoroughly report on each patient’s risk adjustment diagnosis and must be based on clinical medical record documentation from a face-to-face encounter. That means the RAF cannot be wholly determined from test results or patient medical history.

How do you understand HCC and risk adjustment?

• To understand HCC, you need a basic grasp of Risk Adjustment (RA) and vice versa. We’ll break it down for you here. Watch our 19-minute webinar on The ABCs of HCCs! The Risk Adjustment (RA) model uses a patient’s demographics and diagnoses to determine a risk score, which is a relative measure of how costly that patient is anticipated to be.