Featured articleRisk Adjustment Strategy
The Real Cost of Undercoding
Why Leaving Diagnoses on the Table Is a Risk You Can’t Ignore
July 2, 2026•6 min read•Vicky Mahn-DiNicola, RN, MS
Why this matters
Undercoding is not a safe alternative to overcoding. Missed clinically valid diagnoses can erode reimbursement, distort risk scores, and leave an incomplete clinical story that creates financial and compliance exposure.
This article explains why undercoding persists, how missed HCC capture affects Medicare Advantage plans, provider groups, and ACOs, and why documentation integrity requires a prospective, systematic workflow rather than periodic chart reviews or annual HCC sweeps.
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