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Certified Risk Adjustment Coder (CRC)

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Certified Risk Adjustment Coder (CRC)

  /  Certified Risk Adjustment Coder (CRC)

Certified Risk Adjustment Coder (CRC)

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About this course

Certified Risk Adjustment Coder (CRC)

CRC course: A Certified Risk Adjustment Coder (CRC™) should know how to read a medical chart and assign the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). The greater the disease burden of the patient, the higher the patient’s risk adjustment score; if the patient is healthy, the risk adjustment score is lower. A patient’s health status reflects the costs of their healthcare needs. CRCs must ensure provider documentation is up-to-par for HCC coding and that disease processes are coded accurately to follow risk adjustment models. Because HCC coding for risk adjustment requires medical coders to help providers document thoroughly all chronic disease processes and manifestations in the patient’s medical record, CRCs must have a clear understanding of guidelines, regulations, diagnosis coding, and risk adjustment.

  • Review and assign accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office or facility setting (e.g., inpatient hospital)
  • Thoroughly comprehend medical coding guidelines and regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models
  • Understand the audit process for risk adjustment models
  • Identify and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding
  • Understand the anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses
  • Compliance
  • Diagnosis coding – ICD- 10 CM
  • Documentation improvement
  • Anatomy, Medical Terminology, physiology
  • Purpose and use of risk adjustment models
  • Quality care
  • Risk adjustment models

CPC certified with 2 yrs experience in medical coding

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Our course begins with the first step for generating great user experiences: understanding what people do, think, say, and feel. In this module, you’ll learn how to keep an open mind while learning.

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