Certified Risk Adjustment Coder (CRC)

What does the acronym HCC stand for in risk adjustment coding?

1. Risk Adjustment Code

2. Health Care Component

3. Hierarchical Condition Category

4. Health Care Classification

The correct answer is: Hierarchical Condition Category

The acronym HCC stands for Hierarchical Condition Category in risk adjustment coding. This term is crucial within healthcare coding as it refers to a system used to categorize patient diagnoses into specific groups. Each category reflects the severity of the patient's condition and the expected healthcare costs associated with managing that condition over time. The use of HCCs allows for a more accurate assessment of risk and can help healthcare providers manage resources more effectively while ensuring proper reimbursement based on the complexity of patient needs. This system plays a fundamental role in Medicare Advantage plans and other risk-adjusted payment models, helping to ensure that care is appropriately funded based on patient health status.