For the Record

Wendy Gagnon-Dutro, CPC, CAC, director of coding solutions at Aviacode understands the challenges of HCC coding. As with all insurers and auditors, Medicare Advantage plans seem to target providers whose documentation doesn’t reflect ongoing treatment for HCC conditions. Payers want to see that providers are actually treating all of the HCC diagnoses that have the potential to shift the diagnosis-related group (DRG) and not just identifying them within the record and moving on, Gagnon-Dutro says.