HCC Coding Tutorial — How to Code Two HCC Codes in Same Category

HCC Coding Tutorial — How to Code Two HCC Codes in Same Category

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Q: “If you have two HCC codes in the same category such as 250.40 and 250.50 what is the trumping rule?”

A: This is really funny because I think this might be one of our students who submitted this; I didn’t get to see the name, because I use the word “trump” all the time and I’ve not heard anybody else use that term. Yay, for them, submitting this question!

Actually this code, 250.40 is diabetes with renal manifestations, type II diabetic. What is fantastic about Find-A-Code is they have all of the HCC categories. The past one is 12, 21 and 22. They even have the ESRD and the Rx HCC listed when you go in and looks at that code; so, I really like that. Again, it’s an 18 so we know it’s diabetes with chronic complications is what 250.40 is, a category 18.

When you scroll down and you look at 250.50, it’s the same thing but its ophthalmic manifestation. Well, it’s an 18 also. Now, you can see that previously it was an 18 and unlike the other code. But the codes are all the same, they’re both 18s. So, what do you do in this dilemma?

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