The HCC Buddy Blog
Coding tips, guideline updates, and expert insights for HCC coders.
RADV Audit Schedule 2026: What HCC Coders Should Check First
CMS published a RADV audit schedule by payment year. Here is what each date means and what coders should tighten before the review arrives.
2027 MA Rate Announcement: What HCC Coders Need to Know
CMS finalized 2027 MA payment rules on April 6, 2026. No new Part C model, audio-only and unlinked CRR exclusions now final. Here's what changes your workflow.
CY 2026 Midyear Risk Scores: What HCC Coders Should Recheck Before July
The July 2026 midyear run scores January–December 2025 diagnoses, not new 2026 charts. Here's what to recheck before it runs.
The Code Still Exists. The HCC May Not: V28 Mappings Coders Should Recheck
Some ICD-10-CM codes that look fine under V28 no longer carry a payment HCC. Here are the code families where old habits cost you RAF.
Depression Screening in MA Star Ratings: What HCC Coders Should Know
CMS finalized a new MA depression screening Star measure. Here's the coder angle: why a positive screen isn't a diagnosis and what V28 specificity still costs you.
Telehealth Diagnoses For Risk Adjustment: Check The Source Before You Keep The HCC
A telehealth dx can count for risk adjustment — if the source qualifies. Here's what to check before you keep the HCC, including the CY 2027 audio-only exclusion.
CMS Coding Pattern Adjustment 2027: What the 0% Row on the Fact Sheet Actually Means
CMS kept the 5.9% MA coding pattern adjustment for 2027. The fact sheet shows 0% — here's why, and what it means for your chart workflow.
Problem Lists Alone Do Not Validate HCCs: What RADV Auditors Check
A problem list entry isn't enough for RADV. Here's what CMS reviewers actually check, and what you need before keeping the HCC.
AI-Generated Notes Still Need Coder QA Before You Keep the HCC
A clean AI-generated note doesn't make a diagnosis supportable. Here's the QA checklist that still applies before you keep any HCC.
FY 2026 ICD-10-CM Guidelines: What HCC Coders Should Recheck
A practical FY 2026 ICD-10-CM guideline checklist for HCC coders: code path, billable status, Excludes notes, specificity, documentation, MEAT, and V28 mapping.
What AI Can and Can't Do in HCC Risk Adjustment Coding Right Now
A risk adjustment QA perspective on AI in HCC coding, what works, what fails, and what every coder needs to know to stay ahead in 2026.
Best HCC Coding Tools 2026: Honest Comparison
Honest comparison of HCC coding tools in 2026: HCC Coder, Codify, Find-A-Code, ICD10Data, and HCC Buddy. Pricing, features, and which fits your workflow.
HCC Chrome Extension: Why In-EHR Coding Tools Change Everything
How an HCC Chrome extension eliminates tab-switching and brings ICD-10 lookups, HCC mapping, and RAF calculations directly into your EHR browser workflow.
How to Increase HCC Coding Speed: Tips From Coders Who Did It
Practical tips for increasing HCC coding speed from coders who hit 50+ charts per day at 95% accuracy, keyboard shortcuts, batch workflows, pre-visit prep, and tool optimization.
Depression HCC Coding Guide: ICD-10 Mapping and Documentation
Complete guide to depression HCC coding under V28, which ICD-10 depression codes map to HCC 155, why F32.9 does not qualify, and documentation tips for severity specificity.
Obesity and BMI HCC Coding Guide: V28 Changes
Complete guide to obesity and BMI HCC coding under V28, morbid obesity E66.01 mapping to HCC 48, BMI Z68.x secondary codes, documentation requirements, and the 19.4% weight reduction from V24.
Atrial Fibrillation HCC Coding Guide
Complete guide to atrial fibrillation HCC coding under V28, AFib ICD-10 codes I48.0 through I48.91, HCC 238 mapping, documentation requirements, and differences between paroxysmal, persistent, and chronic AFib.
Dementia HCC Coding Guide: Alzheimer's and Vascular Dementia
Complete guide to dementia HCC coding under V28, Alzheimer's, vascular dementia, and unspecified dementia ICD-10 codes, HCC 125-127 mapping, severity documentation, and V28 category changes.
Free HCC Coding Tool: What You Get Without Paying a Dime
What you get with HCC Buddy's free tier, 10 ICD-10 lookups per day with HCC mapping, NPI lookup, drug reference, and RAF calculator, compared to other free HCC coding tools.
ICD-10 Combination Codes That Boost RAF Scores: A Coder's Reference
ICD-10 combination codes bundle a base condition with its complication into a single code that maps to higher-severity HCCs, sometimes increasing RAF value by 3x to 5x. This guide covers the combination code families that matter most for V28 risk adjustment: diabetes with complications, CKD with staging, heart failure specificity, vascular disease with manifestations, and the documentation strategies to capture them.
Risk Adjustment Eligible CPT Codes, 2026 Reference
Which CPT and HCPCS codes qualify for HCC risk adjustment? E/M visits, telehealth, hospital encounters, AWVs, and the RAPS vs EDPS distinction.
CMS-HCC vs HHS-HCC: Key Differences for Coders
Compare CMS-HCC (Medicare Advantage) and HHS-HCC (ACA) risk adjustment models. Timing, HCC categories, ICD-10 mapping, and what coders need to know.
COPD HCC Coding: Specificity & Documentation Guide
COPD and pulmonary disease HCC coding guide. J44.x exacerbation specificity, respiratory failure overlap, V28 mappings, and common pitfalls.
Heart Failure HCC Coding: Systolic vs Diastolic Guide
Heart failure HCC coding guide covering systolic vs diastolic classification, EF documentation, V28 mappings, MEAT requirements, and CHF coding pitfalls.
HCC Coding Cheat Sheet 2026: Quick Reference for Every Risk Adjustment Coder
A practical quick-reference guide for HCC coding in 2026. Top 20 HCCs, V28 hierarchies, MEAT documentation, common mistakes, audit red flags, and recapture checklists.
HCC Hierarchy and Trumping Rules Explained: Which Codes Override Which in V28
HCC hierarchies silently zero out codes you worked hard to capture. This guide breaks down every major V28 hierarchy group, shows which codes trump which, and explains how to stop leaving RAF value on the table.
CKD HCC Coding: Stage Specificity & eGFR Guide
CKD is one of the most under-coded conditions in risk adjustment. Stage specificity, eGFR documentation, and CKD vs ESRD vs transplant status explained.
MEAT Criteria Explained: How Coders Decide When a Diagnosis Is Reportable
A practical, scenario-driven guide to MEAT criteria, Monitor, Evaluate, Assess, Treat, for HCC and risk adjustment coders. Real chart examples for what passes and what fails.
CMS Encounter Data Submission Deadlines: A Plan-Side Reference
When Medicare Advantage plans must submit encounter data and chart-review supplemental files to CMS, what counts as on-time, and how the cutoff dates affect risk adjustment payment.
RADV Audit Prep: How to Pass a Risk Adjustment Data Validation Audit
What CMS RADV auditors actually look for, the medical-record requirements that trip most plans up, and a practical pre-audit checklist for risk adjustment coding teams.
CMS-HCC V28 Transition Guide: What Changed, What It Means for Your RAF
A practical, plan-side guide to the CMS-HCC V28 risk adjustment model. Which HCCs were removed, which were renumbered, the phase-in schedule, and the documentation areas where coders are losing the most RAF.
Provider Query Templates for Risk Adjustment Coders (Compliant Examples)
Compliant, AHIMA-style provider query templates risk adjustment coders can use for diabetes, CHF, CKD, depression, and the most common HCC documentation gaps. With the leading-question patterns to avoid.
CRC Exam Prep Guide: What to Study, How to Practice, and What to Expect
A practical, no-fluff guide to preparing for the AAPC Certified Risk Adjustment Coder (CRC) exam. What the exam actually tests, the study sequence that works, and the reference material you should have open during practice.
Drug-to-Diagnosis Lookup for Missed HCC Opportunities
Medication lists are powerful MEAT evidence signals. Use drug-to-diagnosis crosswalks to surface missed HCC conditions in risk adjustment coding.
RADV Audit Notices Sent to 471 MA Contracts, What to Do Now
CMS sent PY2020 RADV audit notices to 471 Medicare Advantage contracts. Medical record submissions open April 13. What every HCC coder needs to know.
CY 2026 CMS-HCC Risk Adjustment: V28 Is Now 100%
CMS says CY 2026 completes the 2024 CMS-HCC model phase-in for most Medicare Advantage risk scores. Here is what HCC coders should check before trusting the RAF impact.
CMS May Ban Unlinked Chart Reviews from MA Risk Scores
CMS proposed excluding unlinked chart review diagnoses from risk adjustment in 2027, saving $7B+. What HCC coders need to know before the final rule.
OIG MA Compliance Guidance 2026: What Coders Must Know
OIG released landmark Medicare Advantage compliance guidance targeting risk adjustment coding. What HCC coders need to know about chart reviews and HRAs.
April 2026 ICD-10-CM Update: Excludes & Sequencing Changes
April 2026 ICD-10-CM update changes Excludes1 to Excludes2 and rewrites sequencing across 14 chapters. What coders need to do before the effective date.
CMS RADV Audit Expansion in 2026: What HCC Coders Need to Know
CMS is scaling RADV audits from 60 to 550 Medicare Advantage plans per year with 2,000 coders and technology-supported review. Here is what risk adjustment coders must do now to stay compliant.
ICD-10-CM HCC Mapping Tool: What Every HCC Coder Needs in 2026
Discover what an HCC mapping tool actually does, why the ICD-10 HCC crosswalk matters more than ever in the 2026 V28-dominant blend year, and how HCC Buddy gives you instant results inside your browser.
RAF Score Calculator: How to Calculate Risk Adjustment Factor for Medicare Advantage
Step-by-step guide to using a RAF score calculator, inputs required, a worked example, gap analysis workflow, and how HCC Buddy's built-in risk adjustment factor calculator works.
ICD-10 Codes That Do NOT Map to HCC, The List Coders Keep Getting Wrong
A practical reference list of ICD-10-CM codes that do not map to HCCs in the CMS-HCC V28 model, the ICD-10 HCC mapping errors that cost coders time and risk adjustment value.
CMS HCC Model V28 Changes: What Changed and What Coders Need to Know
A practitioner's digest of the 7 CMS HCC V28 changes that most affect day-to-day coding in 2026, with specific codes, new HCC categories, and what to do differently.
Codify vs HCC Buddy: Which Tool Do HCC Coders Actually Need?
A straight comparison of Codify by AAPC and HCC Buddy for HCC coders doing risk adjustment work, features, pricing, and when each tool is the right fit.
Complete Guide to HCC V28 Changes for 2026
Everything medical coders need to know about the CMS-HCC V28 model changes for Payment Year 2026, new categories, deleted HCCs, weight recalibrations, and the V24/V28 blend transition.
Top 10 Most Commonly Miscoded HCCs
Avoid the costliest HCC coding mistakes. Learn the 10 most frequently miscoded HCC categories, why they get wrong, and how to code them correctly every time.
ICD-10 to HCC Mapping Quick Reference
A practical quick reference for ICD-10-CM to HCC code mapping. Learn which diagnosis codes map to which HCC categories, how to look up mappings, and why specificity matters.
Free RAF Score Calculator: How Risk Adjustment Factor Scores Work
Learn how Risk Adjustment Factor (RAF) scores are calculated, what demographic and diagnosis factors contribute, and try a free RAF score calculator for V24 and V28 models.
What Is HCC Coding? A Complete Guide for 2026
Learn what HCC coding is, why it matters for risk adjustment, and how medical coders use ICD-10-CM to HCC mapping in their daily workflow.
ICD-10-CM to HCC Mapping: How It Works
Understand the crosswalk between ICD-10-CM diagnosis codes and HCC categories, including how RAF scores are calculated and why accurate mapping matters.
V24 vs V28 HCC Models: Key Differences Explained
Compare the CMS-HCC V24 and V28 risk adjustment models side by side. Learn what changed, what was removed, and how the transition affects coding in 2026.
Diabetes HCC Coding: ICD-10, V28, RAF, MEAT
Diabetes HCC coding guide for coders: ICD-10-CM specificity, complications, V28 HCC mapping, RAF context, and documentation checks.
MEAT Criteria for HCC Coding: Documentation Requirements
Learn the MEAT documentation criteria, Monitoring, Evaluating, Assessing, and Treating, and why they are essential for capturing HCC codes in risk adjustment.
RAF Score Calculation: A Step-by-Step Guide
Understand how Risk Adjustment Factor scores are calculated, what components make up a RAF score, and why accurate RAF scoring matters for Medicare Advantage plans.
Excludes 1 vs Excludes 2 in ICD-10: What Every Coder Needs to Know
Understand the critical difference between Excludes 1 and Excludes 2 notes in ICD-10-CM coding, with real-world examples and common mistakes to avoid.
HCC Buddy vs Traditional Encoders: Built for HCC Coders, Not Adapted From One
See how HCC Buddy compares to legacy ICD-10 encoders. Built-in HCC mapping, Ask Buddy with sourced answers, NPI lookup, and drug reference, one modern tool built for HCC coders.
Top 10 Most Common HCC Codes Every Coder Should Know
Master the most frequently encountered HCC codes in risk adjustment coding, from diabetes to heart failure, with mapping details and documentation tips.
How to Use an ICD-10 Encoder for Risk Adjustment
Step-by-step guide to using an ICD-10-CM encoder for HCC risk adjustment coding, including search tips, reading code details, and verifying HCC mappings.
NPI Lookup Guide: Finding Provider Information Fast
Learn how to look up National Provider Identifier (NPI) numbers, what information is available, and how NPI data supports HCC coding workflows.