Risk Adjustment Documentation and Coding Boot Camp Online

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Risk Adjustment Documentation and Coding Boot Camp Online

Product Code: OCBO

1st Attendee $999.00*
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to attend this course.

To register multiple attendees, please call our sales team at 615-724-7200.

Don't forget to order the essential CDI resource - The 2021 ACDIS Pocket Guide and FREE access to the all new ACDIS PRO!

Risk Adjustment Documentation and Coding Boot Camp Online

Course Overview

Coding for risk adjustment can feel like searching for a needle in a haystack. Only 13% of diagnosis codes (~8,800 out of about 70,000) are classified as a Hierarchical Condition Category (HCC). Finding those hidden gems in the documentation is of vital importance.

The Risk Adjustment Documentation and Coding Boot Camp Online goes beyond just knowing how to code for a condition. It explores where to obtain coding information as well as where to look for documentation deficiencies to improve overall risk scores. Similar to how implementing a clinical documentation integrity (CDI) department strengthens documentation for DRG assignment, this Boot Camp uses the same principles to improve documentation for risk adjustment.

Risk adjustment uses diagnoses and patient demographics to calculate a payment amount for a beneficiary for a defined period. The methodology focuses on how sick the patient is, rather than how often the patient is seen or evaluated by a provider. Payments are linked directly to the documented conditions in the medical record, not to the number of visits.

The Boot Camp will take you all the way from tackling the concept of risk adjustment and how it is calculated, to focusing on specific diagnoses and conditions that may affect overall risk scores. It will ensure you understand all facets of risk adjustment and help you position your organization to make the best decisions.

Who should take this course?

  • CDI specialists
  • CDI managers and directors
  • HIM managers and professionals
  • Inpatient and outpatient coding managers and professionals
  • Medicare Advantage payers
  • Quality professionals
  • Physicians and nonphysician healthcare professionals
  • Physician practice managers

Our online CDI Boot Camps can be licensed for use within your organization. These can be deployed on your Learning Management system or HCPro’s. Call 877-233-8734 or email NAsales@hcpro.com to discuss our new organizational pricing program.

Risk Adjustment Documentation and Coding Boot Camp Online


Below is the current course schedule for upcoming CDI and Quality Care Measures Boot Camp Online classes.

To view our cancellation policy, click here.



Class Dates

Registration Deadline

March 2021 - May 2021

3/2/2021 - 5/1/2021 3/1/2021

April 2021 - June 2021

4/6/2021 - 6/5/2021 4/5/2021

May 2021 - July 2021

5/4/2021 - 7/3/2021 5/3/2021

June 2021 - July 2021

6/1/2021 - 7/31/2021 5/31/2021

July 2021 - September 2021

7/6/2021 - 9/4/2021 7/5/2021

August 2021 - October 2021

8/3/2021 - 10/2/2021 8/2/2021

Risk Adjustment Documentation and Coding Boot Camp Online

Course Outline/Agenda

  • Module 1: CMS Reimbursement: IPPS, OPPS, and Medicare Advantage Quality Incentives
    • Summary of Medicare Parts A–D 
    • Inpatient Prospective Payment System (IPPS) 
    • Outpatient Prospective Payment System (OPPS) 
    • Medicare Advantage Plans 
    • Prescription Drug Coverage 
  • Module 2: ICD-10-CM Diagnosis Coding: Documentation Sources, Diagnosis Selection, and Official Guidelines
    • Sources of Authority for ICD-10-CM Coding 
    • Documentation Sources 
    • Diagnosis Coding—Inpatient Services 
    • Diagnosis Coding—Outpatient/Professional Services 
    • Uncertain Diagnoses 
    • Signs/Symptoms 
    • Comparative/Contrasting Diagnoses 
    • Acute and Chronic Conditions 
    • Combination Codes 
    • ICD-10-CM Conventions 
      • Excludes notes 
      • Laterality 
  • Module 3: Introduction to Risk Adjustment: Review of Risk Adjustment Methodologies
    • Risk Adjustment Models 
      • HHS-HCCs 
      • Adjusted Clinical Groups 
      • CDPS 
      • DRGs 
      • CMS-HCCs 
    • Demographic Variables 
    • Hierarchical Condition Categories 
      • Applicable settings 
      • Approved providers 
    • Medicare Advantage Plans 
    • Prescription Drug Coverage 
  • Module 4: Hierarchical Condition Categories and the Hierarchies
    • Review of Key Diagnoses From Each HCC 
  • Module 5: Disease Interactions and Disabled Disease Interactions
    • Roles of Disease Interactions in Risk Adjustment 
  • Module 6: Risk Adjustment Validation: RADV Audits

Course outline/agenda subject to change. 

Risk Adjustment Documentation and Coding Boot Camp Online

Learning Objectives

At the conclusion of this educational activity, participants will be able to:

  • Discuss predictive modeling and the concept of risk adjustment
  • Explain how risk adjustment is applied to healthcare reimbursement
  • Explain how risk adjustment is applied to CMS quality measures
  • Identify the different models used in risk adjustment
  • Discuss the process of computing the Risk Adjustment Factor (RAF) score for individuals
  • Describe the process of Risk Adjustment Data Validation (RADV) audits
  • Identify elements within a medical record that can be used to support code assignment
  • Define what is considered a reportable diagnosis
  • Identify the most common conditions found within the HCC risk adjustment methodology
  • Apply the Official Guidelines for Coding and Reporting when assigning codes to these common conditions
  • Identify query opportunities related to documentation deficiencies that would likely impact HCC assignment and RAF score
  • Apply the process of record review for HCC risk adjustment to clinical examples

Risk Adjustment Documentation and Coding Boot Camp Online

Continuing Education

This program has the prior approval of AAPC for 5.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

This program has been approved for 7.5 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 7.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This program has been approved for 5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 7.5 nursing contact hours is provided by HCPro.

CA Board of Nursing
HCPro is approved by the California Board of Registered Nursing to provide 9 nursing contact hours. California BRN Provider #CEP 14494.

Risk Adjustment Documentation and Coding Boot Camp Online


Risk Adjustment Documentation and Coding Boot Camp Online—How does it work?
You’ll receive the same content and instruction that you would experience at our classroom-based, nationally recognized Boot Camps. Here’s how it works:

  • 60-day access after purchase date: View sessions and complete all assignments, including review of all answer keys.
  • 24-hour access: Modules are available at any time of day—you choose the time that works for you. You can also email questions to our instructors. We try to answer all questions either via email or phone within two business days.

How long will the online content remain accessible after class ends?
The online portal location for your class sessions and materials will be available for 60 days from your purchase date.

What is the focus of the Risk Adjustment Documentation and Coding Boot Camp Online?
This course delves into the goals and intent of various risk adjustment methodologies. It will offer an in-depth review of the CMS-HCCs, including how risk adjustment scores are assigned and the process of RADV audits. The Boot Camp will discuss how coding and CDI professionals can affect these processes.

The Official Guidelines for Coding and Reporting will be reviewed as they relate to risk adjustment diagnosis coding. This course will review correct coding for common diagnoses that can impact your risk scores. It will identify opportunities for query and further clarification, and offer tips for provider education.

Does HCPro offer this Boot Camp as an on-site course?
In addition to our open registration courses, we also offer the Boot Camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site, call 800-780-0584 or click on "Train Groups On-Site."

What if I need to cancel or transfer my registration?
Cancellation Policy

Please click here to view our cancellation policy.

Who typically attends this Boot Camp?
This course benefits professional coders, CDI specialists, HIM and CDI directors and managers, providers, physician practice managers, revenue cycle staff, and professionals in the payer setting who administer risk-adjusted plans.

Risk adjustment concepts from the course can also be applied by professionals who monitor quality measures related to the Hospital Value-Based Purchasing (HVBP) Program and the Physician Quality Reporting System (PQRS).

What material does the course cover?
To view the course outline, click on "Course Outline" above.

Does the course require any previous experience or training?
The course is intended as an introduction to risk adjustment methodologies and the application of coding and CDI practices to capture accurate risk adjustment. It is highly recommended that attendees have existing knowledge of basic diagnosis code assignment as well as basic principles of CDI.

This course is NOT intended to teach coding or basic CDI principles.

Does completion of the course lead to any formal certification?
The AAPC offers the Certified Risk Adjustment Coder (CRCÔ) examination. For more information, see https://www.aapc.com/certification/crc/.

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information?
Contact customer service at 800-650-6787 or email customer@simplifycompliance.com.

Risk Adjustment Documentation and Coding Boot Camp Online

Online Boot Camp Staff

Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, is the director of HIM and coding for HCPro. She oversees all of the Certified Coder Boot Camp programs. McCall developed the Certified Coder Boot Camp®—Inpatient Version and the Evaluation and Management Boot Camp™; most recently, she collaborated with the CDI team to develop the Risk Adjustment Documentation and Coding Boot Camp. McCall works with hospitals, medical practices, and other healthcare providers on a wide range of coding-related custom education sessions. She was also one of the first Association of Clinical Documentation Integrity Specialists (ACDIS) Advisory Board members.

Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, is the CDI education director for HCPro. Prescott serves as a full-time instructor for the CDI Boot Camp as well as a subject matter expert for ACDIS.

Prescott is a frequent speaker on HCPro/ACDIS webinars and author of The Clinical Documentation Integrity Specialist’s Complete Training Guide. She started her nursing career in 1985 as a graduate of the University of Vermont School of Nursing. Since that time, she has worked at a variety of organizations, including academic, large, and small community hospitals. She has worked in a number of nursing roles, including as manager in the areas of medical/surgical, ICU, PACU, and endoscopy. Her experience also includes specialization as a compliance officer.

Clinical Validation in CDI Boot Camp Online

2021 ACDIS Pocket Guide: The essential CDI resource

The 2021 ACDIS Pocket Guide is your essential CDI resource. It includes updates to clinical diagnostic standards, the Official Coding Guidelines, ICD-10-CM codes, CMS-HCCs and CDI critical thinking tips! The 2021 ACDIS Pocket Guide is co-written by ACDIS’ CDI Education Director Laurie Prescott, RN, MSN, CCDS, CDIP, CRC, CCDS-O, and a practicing physician steeped in the latest physician documentation terminology, James Manz, MD, CCDS-O.

Be sure to include the #1 CDI resource in your library today!

Bonus: With every purchase of the 2021 ACDIS Pocket Guide, you’ll also have access to the content in ACDIS PRO, our interactive, customizable online tool, which will allow you to easily access your favorite CDI information anywhere, any time!

Want to know more? View a brief 4 minute demo now!

Need to train a group?

Bring our industry-leading instructors to your facility! Hosting a Boot Camp is a cost-effective and convenient solution for training your staff on the latest regulations. For more information, call 877-233-8734 or contact one of our account managers.