HCC Coding and Risk Adjustment 2025 – 400 Free Practice Questions to Pass the Exam

The classification of a chronic illness with severe symptoms and frequent hospital visits as high risk is based on the impact such conditions have on a patient's health and the healthcare system. A high-risk classification typically indicates that the patient is experiencing significant instability in their condition, which can lead to frequent exacerbations requiring interventions or hospitalizations.

Chronic illnesses that are severe often necessitate ongoing and intense management, which can include regular monitoring, complex treatment regimens, and possible emergency care. Patients classified in this way are more likely to incur higher healthcare costs and utilize more healthcare resources, thus justifying the designation of high risk.

In contrast, conditions or patients classified as low or moderate risk tend to exhibit either manageable symptoms or stable disease states, requiring less frequent medical intervention and presenting lower chances of serious health complications. A stable condition indicates that a patient's illness is under control, with minimal symptoms and infrequent need for hospital care, which does not fit the scenario described in the question. Therefore, the appropriate classification for a chronic illness characterized by severe symptoms and frequent hospital visits is indeed high risk.