The Centers for Medicare & Medicaid Service (CMS) risk-adjustment model uses the Hierarchical Condition Category (HCC) method to calculate risk scores based on accurate diagnosis codes reported by providers to Medicare Advantage Plans. This is dependent on complete and accurate coding and documentation to the highest level of specificity to relay the complexity of a patient’s health status. 

This series of activities will offer an introduction for those new to risk adjustment and quality reporting, as well as specialty-specific education for those with an intermediate to advanced understanding of risk adjustment. The process of placing members into the appropriate risk category for resource utilization used by CMS to fund Medicare Advantage (MA) plans will be discussed, along with the importance of documentation and accurate coding in quality programs. Instruction on coding accuracy and documentation to the highest level of specificity will also be offered.

Earn AAPC/CME credit for each on-demand activity completed. These activities are designed to meet the educational needs of coders and physicians that have an interest in learning about the importance of accurate coding and documentation.

You must be logged into your optumhealtheducation.com account to complete the post-activity materials. Please click here for information on how to create an account or to log in.

Once you have logged into your account:

  • Locate the title of the activity you wish to claim credit for in the list below
  • Click on the activity title
  • On the activity page, click the "Register" tab
  • Click the "CONTINUE" button, and then follow the prompts at the bottom of the screen

    Presentations for those new to risk adjustment and/or quality reporting. Click on the activity title to get started.  

    Introduction to MA Risk Adjustment

    Quality Reporting for MA

    Understanding the Medicare Annual Wellness Visit


    Presentations designed for providers. It is highly recommended that individuals attend all six presentation sessions. 
    Click on the activity title to get started.    

    Provider Documentation Focus on Diabetes and Vascular Disease for MA

    Provider Documentation Focus on Chronic Kidney Disease and Hypertension for MA

    Provider Documentation Focus on Obesity and Protein-Calorie Malnutrition for MA

    Provider Documentation Focus on Congestive Heart Failure and Arrhythmias

    Provider Documentation Focus on Dementia and Stroke for MA

    Provider Documentation Focus on Chronic Obstructive Pulmonary Disease and Depression for MA


    Presentations for those who have completed Introduction to Risk Adjustment. Click on the activity title to get started.  

    Fundamental Evaluation and Management (E&M) for Providers

    Comprehensive E&M for Providers


    Specialty-specific presentations for those with an intermediate to advanced understanding of risk adjustment. Click on the activity title to get started.  

    Documenting and Coding Cardiovascular Diseases for MA

    Documenting and Coding Endocrine Disorders for MA

    Documenting and Coding Oncology for MA

    Documenting and Coding Peripheral Vascular Diseases for MA

    Documenting and Coding Substance-Use Disorders for MA

    Documenting and Coding Psychiatric Disorders

    Documenting and Coding for Skilled Nursing Facilities

    Documenting and Coding for Hospitalists

    Documenting and Coding Pulmonary Diseases for MA


    Provided by
    These activities are jointly provided by OptumHealth Education and Optum Risk, Quality & Network Solutions.

    Commercial Support
    There was no commercial support received for these activities.

    If you have questions regarding OptumHealth Education's activities or services, please email: moreinfo@optumhealtheducation.com.