Which statement correctly describes how dates of service affect risk score calculations?

Which statement correctly describes how dates of service affect risk score calculations?

• A. Diagnoses must be resubmitted in the current calendar year to be considered.
• B. Diagnoses from prior years carry over automatically into the current year.
• C. Diagnosis codes must be submitted again in the current calendar year to be considered.
• D. The RAF is calculated without regard to dates of service.

Answer: (C)

Dates of service determine which year's risk adjustment data are counted. For the RAF calculation, diagnoses must be documented with dates of service in the current calendar year to be included. Diagnoses from prior years aren’t automatically carried forward; they need to be submitted again with current-year dates so the current health status is accurately reflected. This is why the correct understanding is that diagnosis codes must be submitted in the current calendar year to be considered. The idea that prior-year codes carry over automatically or that the RAF ignores dates isn’t how the system works.

Dates of service determine which year's risk adjustment data are counted. For the RAF calculation, diagnoses must be documented with dates of service in the current calendar year to be included. Diagnoses from prior years aren’t automatically carried forward; they need to be submitted again with current-year dates so the current health status is accurately reflected. This is why the correct understanding is that diagnosis codes must be submitted in the current calendar year to be considered. The idea that prior-year codes carry over automatically or that the RAF ignores dates isn’t how the system works.