Provider Trainings


Coding tips

In CalOptima’s ongoing efforts to ensure we report accurate coding and proper chart documentation as required by the Centers for Medicare and Medicaid Services (CMS), we have created coding tips on various topics to assist the provider community.

Coding Reference Guide 2018 Download PDF Icon Review the ICD-10-CM diagnosis code descriptions.

Chronic Kidney Disease Download PDF Icon Learn coding and documentation tips for chronic kidney disease (CKD).

Chronic Obstructive Pulmonary Disease (COPD) Download PDF Icon Coding and Documentation tips for COPD and other chronic lung diseases.

CMS Risk Adjustment Data Validation Audit Protocol Download PDF Icon Review the definition of Risk Adjustment Data Validation, types of CMS RADV Audits and other key documentation guidelines.

Diabetes Mellitus Download PDF Icon Tips for coding and documentation of diabetes mellitus in ICD-10-CM.

Documentation Compliance Standards Download PDF Icon CMS requirements for medical record documentation.

Hierarchical Condition Categories Compliance (HCC) Download PDF Icon CMS compliance standards for HCC validation.

Major Depressive Disorder Download PDF Icon Coding and documentation tips for major depressive disorder.

Neoplasm Download PDF Icon Documentation requirements for coding neoplasm in ICD-10-CM.

Progress Notes Download PDF Icon Documentation and guidance for progress notes.

Peripheral Vascular Disease Download PDF Icon Coding and documentation tips for peripheral vascular disease.

Substance Abuse Download PDF Icon Substance abuse documentation tips.


Risk Adjustment Data Validation (RADV) Audit Overview Download PDF Icon Review of CMS RADV Audit policy and procedures.

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