Healthcare Coding: a Little-Known Story

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Healthcare Coding: a Little-Known Story

May 02, 2019
Healthcare coding is much more than letters and numbers on a screen. At InnovAge, it is part of a larger narrative that helps us better understand our participants’ healthcare needs and treat them effectively through the Program of All-inclusive Care for the Elderly (PACE).

Transforming diagnoses into data.
Healthcare coding, or Hierarchical Condition Category (HCC) coding, is the process of translating each patient’s clinical diagnosis into alphanumerical codes in order to help doctors accurately track their health and make informed decisions about treatment.

Healthcare providers then report these codes to the Centers for Medicare and Medicaid Services, which uses them to determine how much the treatment will cost, as well as the World Health Organization (WHO) in order to track population health trends on an international scale.

“Coding is a language and translating it is an art form,” says InnovAge Senior Coding and Compliance Analyst Kathy Boyce. “There’s an HCC code for everything, and it’s always evolving.”

Over 68,000 diagnosis codes exist today, and that number continues to grow every year as WHO adds new health conditions, diseases, and technologies to the list.

Working together to improve care.
The all-inclusive care model of PACE allows HCC coders at InnovAge to collaborate with interdisciplinary care teams at our centers across the country. Coders and primary care providers partner to make sure that every PACE participant is diagnosed correctly and treated effectively.

According to Kathy, “a cold is never just a cold, so it’s my job to help doctors connect the dots by identifying data trends that may explain our participants’ health conditions more comprehensively.”

Using numbers to tell a larger story.
Tracking health trends among PACE participants has impacted the way InnovAge understands and treats those we serve over time.

HCC coding has shed light on many health issues that impact seniors, including:
  • Lower fall-risk among seniors who exercise.
  • Upticks in obesity that correlate with spikes in other conditions, like heart disease and diabetes.
  • How immunization rates can provide insight on how infections spread in different communities.

“We all bring something different to the PACE care team, and HCC is one important piece of the puzzle,” says Kathy. “With accurate data, we can make more informed decisions and provide the highest possible quality of care for every senior we serve.”
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