Risk Adjustment Coding Team

Optimizing your diagnosis coding to reflect accurate risk scoring

Diagnosis coding is increasingly utilized to assess the health status of patients in value-based care. Risk-based health plans utilize claims diagnosis coding, along with patient demographics, to assign patients a “risk score”—a numerical representation of the predicted resources and annual cost needed to manage care, compared to the average patient. Accurate ICD-10 codes that reflect appropriate patient acuity levels are imperative and can lead to better clinical data and improved efficiency.

How does NEQCA’s Risk Adjustment Coding Team help?

Our team provides regular educational programming, data analysis and special targeted projects to help take the guesswork out of risk coding, positioning our practices for optimal accuracy in risk coding. We invite you to browse our library of educational resources, and reach out to our team if you have further questions.

Resources for Providers

This guidance has been compiled by New England Quality Care Alliance (NEQCA) and is based on the most current information available at the time of publication. NEQCA is not responsible for any issues related to billing and reimbursement.

Risk Adjustment Webinars and Resources

Medicare/CMS Coding, Documentation and Billing Guidance

Telehealth Coding and Billing Guidance

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