Auditing HCC Coders

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Auditing HCC Coders

Postby Jmraney » Tue Aug 15, 2017 6:03 pm

We have begun auditing some HCC coders, but I have a few questions before I proceed. If a provider links a diagnosis to a lab within a progress note, would you add the HCC to the claim without any further documentation?

Also, could someone please elaborate on what meeting the MEA and/T means? It it my understanding meeting the MEAT if just one part of the required documentation, there must also be a treatment plan with the stability of the condition documented in order to add the conditions.

Any feedback is appreciated.

Thank you for your time.
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Re: Auditing HCC Coders

Postby admin » Wed Aug 23, 2017 5:28 pm

Here is the break down of the acronym MEAT:

Monitor—signs, symptoms, disease progression, disease regression
Evaluate—test results, medication effectiveness, response to treatment
Assess/Address—ordering tests, discussion, review records, counseling
Treat—medications, therapies, other modalities
If the physician ordered a lab for a condition it would fall under the category of assess, which would support adding that risk adjusted diagnosis.

If you are doing 3rd party auditing it is good to have a quick meeting on the expectations and processes they follow, as well as the risk adjustment module they are using (i.e. CMS module which includes Rx HCC).

You also need to be aware of the payers requirements, sometimes they will have their own processes that is more strict that requires more than one area of MEAT be supported for billing purposes.

Your question has been answered by Stephanie Allard, CPC, RHIT
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