The RCxRules Blog

How RCxRules Can Help You Navigate the Change from V24 to V28

HCC model V28 was recently approved by CMS and will begin to take effect in 2024. The new model will require even greater specificity in documentation and coding. The rollout will involve a slow phase-in with a combination of V24 and V28 in use over a two-year period.

Dealing with multiple models at once is going to be complex—which is where RCxRules comes in. RCxRules has a built-in capability to run multiple models simultaneously. This means the HCC Coding Engine can be configured to respect either model (or combination of models) applicable at the time.

In addition to having all the data needed to run both V24 and V28, RCxRules has built a consolidated model that combines V24 with new codes that are a part of V28. Users can choose to run V24 or V28 on their own, or to run this comprehensive model of all codes that map in either model.

As the phase-in happens, we have the ability to keep up with rapidly changing data and provide easy configuration options to users. Because we’re able to run multiple models, we can accommodate for very specific scenarios and ensure groups are able to address their unique billing and coding needs.

Additionally, our in-depth reporting can help quantify the impact of an HCC coder’s work in both models, meaning groups can see where the biggest impacts are being made. Both models are available to view separately, making it easy to see how the ongoing changes are affecting workflows and productivity.

The HCC Coding Engine can also help educate HCC coders on how each diagnosis code maps to the different models. There is an included functionality that allows users to hover over a diagnosis code to see how it maps to each model. The user can see the new number and name associated with the code.

While the initial plan is for the rollout to take two years, the phase-in timeline and process is always subject to change. Leveraging RCxRules’ technology puts medicals groups in a good position to adjust and react to real-time changes.

To learn more about how the HCC Coding Engine can help you with the transition from v24 to v28, set up a meeting.



Get the latest updates

Receive insights on value-based care, revenue cycle best practices and more!