Improving hierarchical condition category coding by family medicine residents using a web-based, interactive module

Abstract

BACKGROUND AND OBJECTIVES: The proper documentation of Hierarchical Condition Category (HCC) codes is essential for risk-adjusted reimburse-ment, chart accuracy, and clinical communication within primary care, but represents a significant training gap in resident education. Our goal was to improve the understanding and confidence level of family medicine residents with HCC coding during outpatient primary care visits. METHODS: We developed and distributed a web-based, interactive module to family medicine residents at our academic institution. We assessed module impact through pre-and postsurveys focusing on knowledge, confidence, and experience with HCC coding. RESULTS: Twenty-eight of 48 preeducation surveys were returned (response rate of 58%), including 16 junior (PGY-1-2) and 12 senior (PGY-3-4) residents. A majority of residents answered each HCC knowledge question correctly. Median baseline confidence with HCC coding for all respondents was 4 (inter-quartile range [IQR]: 2, 6; scale 0-10; 10=most confident): senior residents 6 (IQR: 5, 7) versus junior residents 2 (IQR: 2, 4). Forty-six percent of respondents noted some previous education on HCC codes, including 75% of senior vs 25% of junior residents. Twenty-six residents completed the educational module. Posttest surveys (n=5, response rate: 19%) demonstrated median confidence of 7 (IQR: 4, 8.5). CONCLUSIONS: Family medicine residents displayed a high degree of knowledge but low confidence with HCC coding. Posteducation surveys suggest the possibility of a positive impact of our e-module, though further intervention roll out and data collection are needed to evaluate this effect.