HCC coding shifting to the V28 model starting Jan. 1, 2024

The Centers for Medicare and Medicaid Services (CMS) is phasing in the V28 model for risk adjustment to replace the V24 model for risk adjustment beginning Jan. 1, 2024. The new model has significant changes to HCC coding and diagnosis mapping.

What’s changing?

Below are highlights of the new V28 model for risk adjustment:

  • The number of HCC categories increased from 86 to 115, and categories were renumbered
  • Changes were made to diabetes coding, a very commonly reported condition
  • Some diagnoses were removed entirely

Why is this important?

Coding accuracy and specificity are essential to capturing a patient’s full burden of illness, ensuring care management programs are offered to the right members and closing gaps in care.

For those participating in an alternative payment model (APM), reimbursement rates have the potential to change due to weight changes for some hierarchal condition categories (HCCs).

Learn how to be successful with the new coding requirements

We’re here to help. Register below for our upcoming webinar, “Understanding HCC coding: an introduction to the new V28 model for risk adjustment” for a comparison of the V24 and V28 models for risk adjustment and an overview of key changes, how these new requirements will impact you and how you can be successful.

Register here:

Tuesday, December 5, 12 P.M.
Thursday, December 7, 3 P.M.