Back to Solutions

Chart Abstraction & Risk Adjustment (HCC)

Accurate Coding for the V28 Era.

Get Started

The rules for risk adjustment have changed

CMS's transition to the V28 HCC model fundamentally changes how risk scores are calculated. Conditions that were previously captured may no longer count. Specificity requirements are higher. Zenexa's certified coding teams are fluent in both V24 and V28 models, ensuring your RAF scores remain accurate through the transition and beyond.

Core Capabilities

V28 Specificity

Our coders are trained on every V28 change—deleted HCCs, merged categories, and new specificity requirements. No more relying on legacy mappings.

MEAT Criteria Validation

Every diagnosis is validated against Monitor, Evaluate, Assess, Treat criteria. If the documentation doesn't support it, we don't code it.

HEDIS & Quality Integration

Risk adjustment encounters double as quality measure opportunities. We capture HEDIS-relevant data during every chart review.

Dual-Model Fluency

During the transition period, we run parallel scoring against both V24 and V28 models so you can see exactly how your RAF scores will shift.