What does Hierarchical imply in HCC coding?

• A. A ranking where higher severity codes can trump others
• B. A fixed list of codes with equal weights
• C. A non-risk adjusting category
• D. Only uses demographic data

Answer: (A)

Hierarchical in HCC coding means related conditions are ranked by severity, and when multiple codes could apply, the most severe one in that group drives the risk adjustment. This ensures the patient’s risk score reflects the greatest impact of their conditions without double-counting milder codes. The hierarchy is about choosing the highest-severity category, not about equal weights, non-risk adjustment, or relying only on demographic data.