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Title: CMS’ Hierarchical Condition Categories (HCCs): The Basics

Original Presentation Date: Thursday, May 21, 2015

Learning Objectives:

  • Explain what HCCs are, and where and how they are used by medicare
  • Use the HCC tables to assign a documented and coded case to an HCC
  • Assess the impact that variations in codes and demographic information can impact HCC assignment and revenue

Presenter: Gail Woytek RHIA, CCS

Gail Woytek RHIA, CCS is a Clinical Reviewer for Cognisight, a leading health care solutions vendor specializing in risk adjustment services for Medicare Advantage plans. She travels throughout the country performing risk adjusted coding reviews for (health care plans) in physician practices and PACE programs. Gail is well-versed in the HIX risk adjustment practices and spends a good portion of her time educating and training other reviewers. Gail’s past experience includes holding health information manager and director positions in several hospitals in Rochester region of upstate New York, while teaching in the health information technology program at Monroe Community College. Gail is active in the Rochester Regional Health Information Management Association (RRHIMA), and received the new York State Health Information Management Association (NYHIMA) Distinguished Member Award in 2014.

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