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Topic starter
Hello All,
I am working on some quality items and noticed a table in the database called 'HCCMapping'. There isn't any documentation on it. Does anyone know the table's purpose?
Thanks,
Brad
Posted : November 23, 2016 2:34 am
Hierarchical Condition Category (HCC) is a category of medical conditions that maps to a corresponding group of ICD-9 / ICD-10 diagnosis codes. It is a CMS programs used to assign RAF's (Risk Adjustment Factors) to beneficiaries of health plans and pay accordingly for their care.
All providers need to get on board to avoid reimbursement deductions. The first step is probably to obtain their QRUR's (Quality and Resource Use Reports) from CMS via the EIDM Account on the CMS portal.
Posted : November 23, 2016 3:43 am
I am curious how we utilize this table.
I am familiar with HCC codes but not how to use this table that is in the database.
Dave
Posted : November 23, 2016 3:48 am
Topic starter
I'm in a similar situation Dave. I'm not sure if the table will be helpful since the problem codes it references are in ICD-9 format. But I figured I would ask in case anyone knows...
Posted : November 23, 2016 3:54 am
I am on CEMR 9.8.13 and my HCCMAPPING table is completely empty.
Posted : November 23, 2016 4:36 am
Topic starter
For what its worth we are on CPS 12.0.11 and the table returns the following:
HCCMappingID
ProblemCode
CodeType
RiskAdjstmentFactor
HCCCode
DB_CREATE_DATE
DB_UPDATE_DATE
I get ~3000 rows. The problem codes are ICD-9 codes. All items have a code type of '1'. The HCCCode seems to relate to the HCC Category, for example: HCC2, HCC39, etc.
Posted : November 23, 2016 5:57 am
This table is for future use. GE is working on integrating Payer data, so when that data is received, it will be populated in there. I believe currently, GE only has of the National Payers setup but not 100% sure. Once the table is populated, the information stored within it will be displayed on the Problem List of the Chart Summary. Donna Maddox from GE did a presentation during C-Live either earlier this year or last year.
Posted : November 23, 2016 6:46 am
