About HCC Buddy

The Story Behind HCC Buddy

HCC Buddy was born out of years of firsthand experience in HCC risk adjustment coding. After spending countless hours navigating clunky, overpriced encoders that were never designed with HCC workflows in mind, the frustration became the fuel to build something better.

The tools available to medical coders have always felt like afterthoughts. Generic code lookup databases with HCC mappings bolted on as a premium upsell. They slow you down when you need speed, bury the information you actually need behind layers of menus, and charge enterprise-level prices for features that should be standard. HCC Buddy was created to change that.

What started as a personal side project, a Chrome extension to speed up chart reviews, quickly grew into a full-featured encoder with ICD-10 code search, HCC category mapping, drug-to-diagnosis cross-referencing, NPI provider lookup, and Ask Buddy. Every feature is shaped around the details coders check during a real chart review.

Our Mission

Make medical coding tools accessible, affordable, and purpose-built for HCC risk adjustment workflows.

HCC Buddy is not a faceless corporation. It is a practical coding tool shaped around real chart review work. Every design decision, feature priority, and pricing choice starts with one question: does this actually help the person doing chart reviews?

How the Data Stays Current

Coding accuracy depends on which data set the encoder is reading from on any given day. HCC Buddy maintains four independent corpora and refreshes each on a fixed cadence so coders never have to wonder whether an answer reflects last fiscal year or this one.

• ICD-10-CM tabular list. Loaded directly from the CMS ICD-10-CM release page. The October 1 fiscal-year release ships within 30 days of the official effective date, and the April 1 mid-year update ships on the same cadence. Historical FY2016 through FY2025 code sets remain searchable for retrospective audit work.
• CMS-HCC V28 model. Sourced from the CMS Risk Adjustment Model Output. V28 is at 100 percent phase-in for payment year 2026 and is the default model the encoder shows beside every HCC-mapped code. Coefficients are imported directly from the public model file, not transcribed.
• CMS-HCC V24 model. Maintained alongside V28 so coders working retrospective claims, RADV samples, or PY 2024 / 2025 work can compare the two side by side without switching tools.
• NPPES NPI registry. Pulled from the CMS NPPES weekly export. Provider records (currently 9.37 million) refresh nightly so a credential check inside the encoder reflects the same data the National Plan and Provider Enumeration System publishes.

Documentation Methodology

Every billable code on HCC Buddy carries the same documentation scaffolding: ICD-10 inclusion and Excludes 1 / Excludes 2 notes, the Code First / Use Additional Code hierarchy, V28 and V24 HCC mapping with RAF coefficient, sibling codes for related specificity, and MEAT-criteria documentation tips.

The MEAT framework (Monitor, Evaluate, Assess, Treat) is the standard CMS auditors apply during a Risk Adjustment Data Validation (RADV) review. HCC Buddy does not interpret MEAT for any specific patient encounter. It surfaces the documentation prompts a coder should be looking for so that a diagnosis with a clean ICD-10 mapping is also a diagnosis with clean clinical support.

Editorial content (blog posts, condition guides, coding tips) is reviewed by Jess P., CPC, a Certified Professional Coder credentialed by the AAPC, against the active fiscal-year ICD-10-CM tabular list and the current CMS-HCC model. Posts are dated and the review date is shown alongside the byline.

Privacy Posture

HCC Buddy is a coding-reference tool. The encoder, Ask Buddy, the Chrome extension, and the API all operate on ICD-10 code numbers, drug names, NPI numbers, and clinical concepts. No member identifiers, dates of birth, member IDs, or chart text. A PHI scanner runs on every Ask Buddy question before it leaves the browser; queries that look like they contain identifying data are rejected client-side with a specific reason so the coder can deidentify and resubmit.

Nothing about a chart review is stored on our servers in identifiable form. Smart Notes save to local storage on the coder’s device by default; if a coder opts into cloud sync, only the deidentified note text is transmitted. This posture is what lets coders use HCC Buddy on monitored work networks without triggering compliance review.