Billing & Reimbursement: HCC Coding - Audit Criteria

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About this course

This course provides an in-depth look at Hierarchical Condition Category (HCC) coding audit criteria. Areas reviewed include audit purpose and criteria, as well as record review and submission options.


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  • Review the criteria for quality audits and discuss their purpose.
  • Explain Medicare Risk Adjustment Data Validation (RADV) Audits and explore its advantages and disadvantages.
  • Learn about the Initial Validation Audit (IVA) and provide an overview of the guidelines.
  • Explore options regarding record reviews and submissions.
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