What this is, where the data comes from, and what it will not do.
An ICD-10-CM encoder built for risk adjustment. It answers three questions a code book answers badly: what does this code mean, what does the index actually say about getting to it, and is this set of codes valid together.
It is operated by Innova Health Strategies. It is a reference and validation tool — not a clearinghouse, not a billing system, and not a medical device.
Mapping and scoring are counted separately on purpose. Knowing what a code mapped to in a past payment year is not the same as being able to say what it scored, and a page that merged the two would be overstating. The RADV page breaks the same coverage down year by year, queried live.
All of it is public-domain federal data, loaded from the source files rather than retyped: ICD-10-CM from CMS and NCHS, the CMS-HCC, RxHCC and ESRD risk models from the CMS model software packages, the HHS-HCC model from the CCIIO DIY tables, provider records read live from NPPES, and the medication data from the NLM and FDA.
Nothing here republishes licensed content. AHA Coding Clinic, the ACDIS pocket guide, CPT and commercial drug databases are other people's property, and where the product would benefit from them it shows an empty slot rather than someone else's words.
It never suggests what would pay more. No RAF-lift estimates, no score deltas, no ranking of candidate codes by value. Surfacing an Excludes1 conflict or a missing 7th character is documentation accuracy. Sorting candidates by payment impact is a different product, and in a False Claims Act case the disclaimer is an exhibit rather than a defence.
It never asks for patient information. The worksheet lives in your browser, the risk calculator stores nothing, and batch scoring passes your own member key straight through without interpreting it. There is no reason for this tool to hold PHI and it does not.
It never invents a number. Where a coefficient is missing the score is reported as a floor rather than a total, and where a model cannot be scored correctly it is not offered at all.
If you have found something wrong in the data, the feedback control at the bottom of every page sends the code and the page along with your note, which makes it far quicker to fix. Please do not paste anything from a chart into either — neither is a secure channel for it.
