A billing clerk proposes copying last year’s HCC-mapped diagnoses o…

Question

A billing clerk proposes copying last year’s HCC-mapped diagnoses onto this year’s claims without clinician revalidation. What is the correct coding response?

Accepted Answer

Do not carry forward risk-adjustment diagnoses without current-year clinical documentation and validation — Copy-paste from last year’s HCC list is not clinical validation. This year’s chart has to show the conditions still live in the care story. No revalidation, no free pass to clone the risk codes.

Answer

Copy all prior HCC codes automatically to protect RAF scores

Answer

Carry forward codes only when the patient has not been seen in two years

Answer

Allow problem-list cloning if the EHR shows a green checkmark next to each code

A billing clerk proposes copying last year’s HCC-mapped diagnoses onto this year’s claims without clinician revalidation. What is the correct coding response?

Short Explanation

Full Explanation