As you have heard, the CMS-HCC Model will change slightly in 2011 with basically some re-organization of ICD-9s into different categories.

Here is a link to the first draft of the codes for 2011.  The final version is expected April, 2010.  This link is to just a numeric crosswalk, I will try to compile a complete file in English in the next few days.

3 Comments

• 

  By dculling, March 7, 2010 @ 8:24 PM

  Matt,

  My understanding is that there are a few significant changes to the 2011 model. For example, all DM with complication codes will be rolled up into one code; also there are some new HCC Categories including Dementia. Also, I understand that there will be a 8% reduction in premium revenue paid to MCOs. Can you confirm?

  Thanks,

  Doug
• 

  By dculling, March 11, 2010 @ 12:46 PM

  Matt,

  Another question: Is it your understanding that the 2011 payments for 2010 coding will be based on the new model with the new and changed HCC codes that just came out?

  Thanks,

  Doug
• 

  By jmarino, March 30, 2010 @ 11:37 AM

  Hi Matt,
  I was just reviewing the Rx HCC for 2011 off of the link you gave us for the CMS website.
  If I am looking at the correct spreadsheet (prelim mapping Rx HCC), it looks like quite a few conditions are dropping off.
  DJD for one plus a lot of other very common conditions.
  Is this correct or am I missing something?
  Thank you,
  Judy

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