Audit readiness resource
2026 RADV, MEAT, and SOE Checklist
Use this checklist before charts are pulled. It helps HCC coding teams review whether a diagnosis is documented, supported by MEAT, and defensible from the source of evidence.
Checklist
- Confirm the provider documented the diagnosis for the encounter under review.
- Identify at least one MEAT element: monitor, evaluate, assess, or treat.
- Check whether the source of evidence supports the exact ICD-10-CM specificity coded.
- Flag problem-list-only diagnoses for manager review.
- Separate supported, needs-review, and unsupported diagnoses before chart-pull pressure starts.
- Use current ICD-10-CM and CMS-HCC model context when checking HCC mapping.
Unsupported Diagnosis Risk Patterns
A chronic condition is copied forward but not addressed in the note.
Medication suggests a condition, but the provider did not document the diagnosis.
The coded specificity is stronger than the provider wording.
A historical condition is coded as active.
A mapped HCC is treated as final before evidence support is reviewed.
How HCC Buddy Supports This Review
HCC Buddy connects the ICD-10 encoder, HCC mapping, RAF workflow, evidence checker, MEAT guidance, and Chrome extension so coders can move from code lookup to support review without losing context.