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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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The Real Cost of Undercoding

Why Leaving Diagnoses on the Table Is a Risk You Can’t Ignore

July 2, 2026Read

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