cpt_hcpcs: RA-eligible CPT and HCPCS - Table 2

In edgedata: Datasets that Support the EDGE Server DIY Logic

Description

A dataset containing the Current Procedural Terminology (CPT) and Health Care Procedure Coding System (HCPCS) codes that determine if a claim is eligible for risk adjustment.

Usage

cpt_hcpcs

Format

An object of class tbl_df (inherits from tbl, data.frame) with 6557 rows and 8 columns

code

CPT/HCPCS code

desc

Short description of the code

prior

Whether or not the code was valid in the prior benefit year

curr

Whether or not the code is valid in the current benefit year

footnote

Any footnotes included in the CMS DIY file

Details

Risk adjustment requires that claims be face-to-face to count in the HHS-HCC model. The codes in this dataset denote a face-to-face procedure, so if one of these codes is found anywhere on a claim, it counts for risk adjustment.

Source

Data import and cleaning at: https://github.com/EeethB/edgedata/tree/main/data-raw

See Also

Other HCC tables: adult_group, adult_hcc, adult_interaction, adult_rxc_hcc_inter, cc_hier, child_group, child_hcc, icd_cc

edgedata documentation built on Feb. 27, 2021, 1:05 a.m.