Go beyond just the diagnoses — really understand the methodology behind Hierarchical Condition Categories! Prepare for the future of healthcare reimbursement with HCC: Essentials of Hierarchical Condition Categories Coding, by nationally recognized HCC authority Rose T. Dunn, MBA, RHIA, CPA, FACHE.
HCC: Essentials of Hierarchical Condition Categories Coding
Rose T. Dunn, MBA, RHIA, CPA, FACHE
$220.00
CEUs: 6 6 AHIMA 6 AAPC
Included in eLearning Library. Price per person. Group rates available.Overview
This course reflects the CMS-HCC model V28 methodology fully implemented in 2026. Examples of codes and HCC risk scores are offered for illustration only. The concepts being taught and the basic tenets of HCC coding would be applied to the actual codes and HCC risk scores for the relevant service period.
Designed for the experienced coding professional who is ready to really understand the methodology behind HCCs. Prepare for the future of healthcare reimbursement with HCC: Essentials of Hierarchical Condition Categories Coding. The online, self-paced course provides comprehensive instruction to ensure complete and accurate HCC coding to improve data quality and ensure appropriate reimbursement.
Ready to achieve your Certified Risk Adjustment Coder (CRC)® certification? HCC: Essentials of Hierarchical Condition Categories Coding can help you prepare. See eLearning Library: HCC Coding for the complete list of recommended courses.
HCC: Essentials of Hierarchical Condition Categories Coding will provide you with the in-depth knowledge and command of the HCC system to ensure coding is accurate, supported by documentation, and that reimbursement is appropriate.
- What are Hierarchical Condition Categories (HCCs)?
- What is Risk Adjustment?
- How is the HCC Risk Adjustment Factor (RAF) calculated?
- What are the documentation requirements for providers in an HCC environment?
- How should one prepare for an external HCC audit?
Lesson 1:
History of Risk Adjustment
Why HCCs were implemented
Structure of HCCs
Where do we find HCCs?
Lesson 2:
HCC Principles
Common HCC Models
CMS-HCCs
ESRD HCCs
PACE HCCs
Pharmacy HCCs
HHS-HCCs
CDPS
CRG model
Lesson 3:
How are HCCs Calculated
Medications
CPT® Influence
Understanding the Diagnosis to CMS-HCC Map
Understanding the CMS-HCC Relative Factors Grid
CMS-HCC Relative Factors
Lesson 4:
Reimbursement Methodology
What is the RAF?
Calculating the Risk Adjustment Factor
Applying the Denominator
Annual Update and Reset
Our Compliance Role
Lesson 5:
About Medicare Advantage
Version 28 of the CMS HCCs
Calculating the RAF During the Blending Period
The level of effort to complete this course, start to finish, is equivalent to 6 CEUs and should take you approximately 6-18 hours to complete. Remember: You have access to the course materials for the full 16-week enrollment period and we encourage you to re-review any materials that are helpful to you.
Certificate of Completion
Upon successful completion of the course work, student will be able to download a Libman Education Certificate of Completion. The Certificate of Completion will list the course as awarding 6 CEUs.
AHIMA: 6 CEUs
This course has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.
AAPC: 6 CEUs
This course has the prior approval of AAPC for continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
- WebinarPlus™ multimedia and interactive online training format promotes engagement with challenging materials while offering independent self-study.
- Downloadable and printable “Course Highlights” saves time! This active learning tool assists with mastery of the course content.
- Teaching methods including audio and video files, diagrams, and animations to accommodate different learning styles. Where appropriate, the Merck Manual Professional Version supplements course materials with in-depth descriptions of diagnoses and/or procedures.
- Knowledge checks and/or final assessment ensure mastery of material.
- Online Flexibility! Materials available via secure Learning Management System (LMS). Work at your own pace — save time and travel costs.
- Earn Libman Education Certificate of Completion and CEUs.
- To receive CEU credit, students must achieve a passing rate on the course assessment(s).
- Course is self-paced. For planning purposes, assume 1-3 hours required for each CEU.
- Unlimited course access during enrollment period. For courses offering greater than one CEU, enrollment period is 16 weeks. For courses offering one or fewer CEUs, enrollment period is 4 weeks. Courses purchased as a bundle or package may have a longer enrollment period.
- Extensions to the enrollment period are available.
- Price listed is per person/per course. Group rates available upon request.
Rose T. Dunn, MBA, RHIA, CPA, FACHE
Rose Dunn is the Chief Operating Officer of First Class Solutions, Inc., a healthcare information management leader since 1988, offering professional consulting services in health information management operations and information governance issues, as well as coding support, coding quality reviews, privacy/security guidance, temporary (interim) management, revenue cycle oversight, and accreditation preparation. Rose jumped into the weeds of ICD-10 more than 10 years before it was implemented and has been getting back into the weeds of HCCs for the last 2 years. Rose is the author of Libman Education’s online course: Fundamentals of HCC Coding as well as “The Revenue Integrity Manager’s Guidebook” available from the National Association of Healthcare Revenue Integrity and other books on coding management and auditing. Ms. Dunn holds a B.S. and M.B.A. from Saint Louis University.
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Required Resources:
- ICD-10-CM Code Book – 2026 or students may elect to use electronic files
Recommended Resources:
- Risk Adjustment Documentation & Coding
(American Medical Association) - Medical dictionary
- Anatomy and physiology reference
- Merck Manual
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