The federal government reimburses Medicare Advantage plans, like Blue Advantage^®, based on the documented health of their members through a method used by CMS called "Risk Adjustment." This reimbursement is based on the anticipated cost of members' healthcare and is what health plans rely on to accurately estimate healthcare costs and provide high-quality affordable Medicare Advantage products.

Providers play an important role in the risk-adjustment process. Medical record documentation and claims coding data are used to help indicate the complete picture of health for plan members. This data also enables Blue Advantage to analyze and design programs to help manage member care.

Documentation and coding must mirror one another in order to accurately capture the patient's complete picture of health. Use our resources below to provide the most accurate, complete coding and documentation possible.

Documentation and Coding Tips

• Annual Wellness Visit and Routine Physical Exam Guide
• Annual Wellness Visit Tips and Best Practices 
• Common HCC ICD-10 Codes
• Quality Measures Coding Guide
• Advanced Illness and Frailty Guide
• Documentation and Coding Guides by Condition: 
  • Aneurysms
  • Atherosclerosis
  • Cancer
  • Carotid Artery Disease
  • Cerebral Infarction, Transient Ischemic Attack (TIA) and Sequela
  • Chronic Lower Respiratory Disease
  • Congestive Heart Failure
  • Deep Vein Thrombosis (DVT)
  • Depression
  • Diabetes - Type 1
  • Diabetes - Type 2
  • Hypertensive Chronic Kidney Disease
  • Hypertensive Heart and Chronic Kidney Disease
  • Hypertensive Heart Disease
  • Weight-Related Diagnoses
• Documentation and Coding Guidance

• ICD-10Data.com Medical Coding Reference

Documentation and Coding Videos

The following quick videos provide documentation and coding information related to these conditions:

Cancer

COPD

Depression

Diabetes

Heart Failure

Rheumatoid Arthritis

Vascular - Part One

Vascular - Part Two