Frequently Asked Questions
Find quick answers to the questions we hear most often. Can’t find what you’re looking for? Reach out through our contact page.
What is HCC Coder?
HCC Coder is web-based Risk Adjustment coding software for finding, verifying and scoring Hierarchical Condition Category (HCC) codes. It brings ICD-10-CM codes, HCC mappings, risk calculators and coding references into one application, so coders and auditors don't have to switch between tools. HCC Coder is made by innoviHealth Systems, Inc. of Spanish Fork, Utah.
How is HCC Coder different from other Risk Adjustment coding tools?
HCC Coder is built specifically for risk adjustment, not general-purpose coding. Key differences include:
Purpose-built: Every feature is designed around HCC coding and RAF scoring workflows.
Fast lookups: Click-A-Dex index search and lay descriptions get you to the right code quickly.
Built-in calculators: HCC risk calculators are integrated directly into the coding workflow.
Who uses HCC Coder?
HCC Coder is used by risk adjustment professionals across the healthcare industry, including:
Medical coders working in risk adjustment and HCC coding.
Health plans and provider groups managing Medicare Advantage and ACA populations.
Auditors and CDI specialists validating documentation and RAF accuracy.
What features are included in each HCC Coder plan?
Each plan builds on the one below it:
Standard: ICD-10 CM codes, HCC codes, HCC risk calculators, lay descriptions, Click-A-Dex index search, and the ACDIS Outpatient Pocket Guide.
Pro: Everything in Standard, plus advanced RAF calculation tools, team management, and priority support.
Enterprise: Everything in Pro, plus the AHA Coding Clinic and AHA digital book, Medicaid CDPS, CDPS+Rx and MRX, Single Sign-On (SSO), and custom branding.
Does HCC Coder give me access to AHA Coding Clinic?
Yes. AHA Coding Clinic® is available directly within HCC Coder when added to a Standard or Pro subscription, or included in an Enterprise subscription package, Official coding guidance is one click away from the code you're reviewing to help you stay accurate and consistent, and speed up your Risk Adjustment audits.
What results do organizations see with HCC Coder?
Organizations using HCC Coder have reported a 20% reduction in RADV audit error rates and a 50% improvement in charts completed per day. Those gains come from having codes, HCC mappings and references in one place, which reduces both lookup time and coding errors.
How does code and keyword search work in HCC Coder?
You can search HCC Coder by code or by keyword. Each ICD-10-CM code page shows the code at its highest specificity and highlights Excludes, Code Also and Use Additional notes, with links to each related code. Most codes include an anatomy illustration and a "code in context" view that matches the printed code book.
Does HCC Coder support CMS-HCC V28 and HHS-HCC models?
Yes. HCC Coder includes current HCC mappings, and its ACDIS Outpatient Pocket Guide covers CMS-HCC V28 and HHS-HCC V08 categories along with MEAT criteria, diagnostic criteria, CDI tips and sample provider queries.
How can I try HCC Coder or calculate a RAF score?
You can use the free interactive HCC RAF Calculator at hcccoder.com, or schedule a free product demo with an account representative at go.hcccoder.com/demo. You can also contact the sales team at sales@hcccoder.com or (385) 288-1400.
