Risk Adjustment Documentation and Coding Boot Camp

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Risk Adjustment Documentation and Coding Boot Camp

Product Code: OCBC

1st Attendee $1,399.00*
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Risk Adjustment Documentation and Coding Boot Camp

Course Overview

Risk adjustment requires coding and CDI professionals to work together as one team to ensure the capture of the most appropriate risk score for each patient.

If you’re looking for ways to expand your CDI department into outpatient settings and services—all of which can impact risk scores—you’ll find it in theRisk Adjustment Documentation and Coding Boot Camp.

The Risk Adjustment Documentation and Coding Boot Camp reviews both inpatient and outpatient coding guidelines and their application to the CMS-Hierarchical Condition Category (HCC) methodology, and includes detailed instruction on the individual HCCs and identification of opportunities for improved documentation. Clinical scenarios are used to demonstrate concepts and validate learning.

This Boot Camp goes beyond just knowing how to code for a condition. It explores where coding information may be obtained as well as where to look for documentation deficiencies to improve overall risk scores. Similar to how implementing clinical documentation integrity (CDI) departments improves documentation for DRG assignment, this Boot Camp uses the same principles to improve documentation for risk adjustment.

The Risk Adjustment Documentation and Coding 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. It will also offer strategies to reduce your facility’s vulnerability to Risk Adjustment Data Validation audits (RADV).

This three-day course can also help prepare you for the Certified Risk Adjustment Coder (CRC) examination offered through the AAPC.

Who should attend? 

  • 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

For more detailed information about the Risk Adjustment Documentation and Coding Boot Camp, contact customer service at 800-650-6787 or email customer@simplifycompliance.com.

Risk Adjustment Documentation and Coding Boot Camp

Course Locations & Dates

Below is the current course schedule for upcoming classes of this Boot Camp. We update this schedule on a regular basis. 

Registrations are processed in the order received. Class size is limited, and classes often sell out. We recommend against making travel arrangements until after we have confirmed your course registration. 

To register for a class, click the "Register" button. If you would like to register multiple attendees, fill in the "Additional Attendees" box or call our sales team at 615-724-7200 or email us at PD-IS@SimplifyCompliance.com.

Locations marked as "Tentative" are subject to change. To view our cancellation policy, click here.

July 2021

Sterling (Dulles), VA


July 19 – 21, 2021
8:00 a.m. – 5:00 p.m. (Day 1–2)
8:00 a.m. – 3:00 p.m. (Day 3)

Hyatt Place Sterling/Dulles Airport-North
21481 Ridgetop Circle
Sterling, VA 20166
Hotel website

Room Rate: $129/night
Room Rate Cut-Off: July 5, 2021


September 2021

Pittsburgh, PA


September 13 – 15, 2021
8:00 a.m. – 5:00 p.m. (Day 1–2)
8:00 a.m. – 3:00 p.m. (Day 3)

Courtyard Pittsburgh Shadyside
5308 Liberty Avenue
Pittsburgh, PA 15224
Hotel website

Room Rate: $89/night
Room Rate Cut-Off: August 22, 2021


November 2021

Schaumburg (Chicago), IL


November 8 – 10, 2021
8:00 a.m. – 5:00 p.m. (Day 1–2)
8:00 a.m. – 3:00 p.m. (Day 3)

Hyatt House Chicago/Schaumburg
1251 American Lane
Schaumburg, IL 60173
Hotel website

Room Rate: $109/night
Room Rate Cut-Off: October 9, 2021



Risk Adjustment Documentation and Coding Boot Camp


Module 1: Introduction to CMS Reimbursement

  • Summary of Medicare Parts A-D
  • Inpatient Prospective System (IPPS)
  • Outpatient Prospective System (OPPS)
  • Medicare Advantage Plans
  • Prescription Drug Coverage

Module 2: Diagnosis Selection and Documentation

  • 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

Module 3: Introduction to Risk Adjustment

  • Risk Adjustment Models
    • HHS- HCCs
    • CDPS
    • Elixhauser Comorbidities
    • DRGs
    • CMS-HCCs
  • Demographic Variables
  • Hierarchical Condition Categories
    • Applicable Settings
    • Approved Providers
    • Hierarchies
    • Disease & Disabled Interactions
  • Medicare Advantage Plans
  • Calculating a Risk Score
  • The Role of Disease Interactions

Module 4: The “Hierarchies”

Module 5: Risk Adjustment Data Validation Audits (RADV)

  • Historical necessity for RADV audits
    • OIG Work Plan 2017-2018
    • Fraud Investigations
    • What is a RADV audit?
    • Impacts of RADV audits
    • RADV submission requirements/checklists
    • Querying for clinical validity
    • Internal auditing/reviews

Module 6: Compliant Query Practice

Course Outline/Agenda subject to change.

Risk Adjustment Documentation and Coding Boot Camp

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 reimbursement in healthcare 
  • 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 Hierarchical Condition Categories (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

Continuing Education

Association of Clinical Documentation Integrity Specialists (ACDIS)
This program has been approved for 22.5 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

This program has the prior approval of AAPC for 22.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

American Health Information Management Association (AHIMA)
This program has been approved for 22 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Accreditation Council for Continuing Medical Education (ACCME) 
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 22.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity

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

This educational activity for 22.5 nursing contact hours is provided by HCPro.

California Board of Registered Nursing 
HCPro is approved by the California Board of Registered Nursing to provide 27 nursing contact hours. California BRN Provider #CEP 14494. 

Disclosure Statement: 
HCPro has confirmed that none of the faculty/presenters, planners, or contributors have any relevant financial relationships to disclose related to the content of this educational activity.

Risk Adjustment Documentation and Coding Boot Camp


What is the focus of the Risk Adjustment Documentation and Coding Boot Camp? 
This course delves into the goals and intent of various risk adjustment methodologies. It will offer an in-depth review of the CMS Hierarchical Condition Categories (HCC), including how risk adjustment scores are assigned and the process of Risk Adjustment Data Validation (RADV) audits. The Boot Camp will discuss how coding and clinical documentation integrity (CDI) professionals can affect these processes. 

The Official Guidelines for Coding & Reporting will be reviewed as it relates 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? 
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? 
To view our cancellation policy, click here

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

Risk adjustment concepts from this class 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 (CRC) examination. For more information, see https://www.aapc.com/certification/crc/

How is the course taught? 
The course is taught using a combination of lecture, class discussion, and hands-on exercise/case studies. 

What do I need to bring to class? 
When you arrive at class, you will receive an extensive notebook of course materials. In addition, please bring the following to all classes: 

  • Current ICD-10-CM Manual 
  • A highlighter 
  • A notebook for taking notes 
  • Sticky notes/flags 
  • A pen/pencil 

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 that 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." 

Does completion of this course assist with preparation towards formal certification?
ACDIS CCDS-O offers a CDI certification related to the outpatient setting. This course will assist in preparation related to exam objectives that focus on risk adjustment.

How do I get more information? 
Contact our sales team at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Risk Adjustment Documentation and Coding Boot Camp

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!

Risk Adjustment Documentation and Coding Boot Camp

COVID Safety

Simplify Compliance places the highest priority on the safety of our guests. We will follow safety guidelines and advisements for meetings as outlined by the CDC and the WHO, as well as state and local mandates. In preparation for attendance at our events, we want to share the following measures to promote health and wellbeing.

  • At this time, all hotel guests are required to wear a mask while in public areas of the hotel and anywhere that social distancing measures cannot be met.
  • Meeting rooms will be set to comply with CDC, WHO, and applicable locally recommended social distancing guidelines.
  • Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that the host hotel has implemented, please see the information listed on their website, found under the 'Locations/Dates' tab.

Simplify Compliance will continue to monitor the COVID-19 environment, the recommended guidelines, and communicate adjustments to the onsite policies and procedures as we approach the live event date.