Consider this list of the common failures for risk adjustment:

• Failure to capture HCCs at least once every year.
• Failure to ensure diagnosis code(s) billed are consistent with medical record documentation.
• Failure to assign diagnosis code with the highest degree of specificity.
• Failure to document cancer status and treatment.
• Failure to document according to the M.E.A.T. principles. Diagnoses need to be monitored, evaluated, assessed/addressed, and treated.
• Failure to annually document status Z codes and chronic conditions.
• Failure to use a linking statement or document a causal relationship for manifestations and complications.
• Failure to add any diagnosed HCCs to both the chronic problem list and the acute assessment.
• Failure to evaluate each of the HCCs updates on a semiannual basis.
• Failure to review all specialist documentation related to cardiology, master discharge summaries, radiology, specialty correspondence, pulmonary, echocardiograms, and x-rays, laboratory results, and previous encounters.
• Failure to submit more than the standard four ICD-10-CM codes. (allows up to 12)