AAPC CRC UPDATED ACTUAL Questions and
CORRECT Answers | A+ Verified | 2026
which medicare part is reimbursed based on the risk adjustment models -✓✓ part c
• who typically employs risk adjustment coders -✓✓ health plans
• is a health plan required to follow the minimum necessary rule -✓✓ yes, health plans
are covered entities and are therefore required to follow the minimum necessary rule
• what is an example of fraud -✓✓ reporting a diagnosis or co-morbidity that does not
exist to obtain higher reimbursement
• which part of medicare is also called medicare advantage -✓✓ part c
• which health insurance assistance program is sponsored by federal and state
governments -✓✓ medicaid
• what OIG document should a medicare advantage participant review for potential
problem areas that will receive special scrutiny in the upcoming year -✓✓ OIG work plan
• which code set is used by risk adjustment coders -✓✓ icd-10-cm
• which regulation strengthens HIPAA rules by addressing privacy and security
concerns associated with the electronic transmission of health information -✓✓ Health
Information Technology for Economic and Clinical Health Act (HITECH)
• what is coding -✓✓ translating a written or dictated medical record into a series of
alphanumeric codes
• which organ is in the thoracic cavity -✓✓ lungs
• what does the term distal indicate -✓✓ farther from the point of attachment
• blood is received back into the left atrium of the heart through.... -✓✓ pulmonary veins
• the root of the nail is also known as what -✓✓ germinal matrix
• the documentation states: Past Surgical history: she had a lumpectomy of the breast
for DCIS 12 years ago which successfully eradicated the CA
how would this be reported -✓✓ personal history of breast cancer
, • the documentation states: soft druse, some calcified
what system would have this documentation -✓✓ ocular
• which organ does pulmonary refer to -✓✓ lungs
• what is a PEG tube -✓✓ a tube inserted into the stomach for long term feeding
• angina pectoris refers to which system -✓✓ cardiovascular
• what is cholelithiasis -✓✓ stones in the gallbladder
• a patient with diabetes type 2 presents with ED. after examination, the provider
diagnosis the patient with ED due to diabetic autonomic neuropathy. -✓✓ e11.43, n52.1
• a patient is transported from the nursing home for facial drooping, slurred speech, and
dizziness. the patient was admitted for testing. after an MRI, the provider diagnosed the
patient with a TIA -✓✓ g45.9
• the physician was called to the hospital floor for the medical management of a patient
admitted one day ago with a reduced oxygen level due to aspiration pneumonia and
COPD. no chest pain at present, but still SOB and some swelling in his lower
extremities. patient was tachypneic yesterday; lungs reveal course crackles in both
bases, right worse than left. the physician writes instructions to continue with
intravenous antibiotic treatment and respiratory support with ventilator management. he
reviewed the chest X-ray which shows gastric contents in the lungs and labs. patient is
improving and a pulmonary consultation has been requested -✓✓ j69.0, t17.810a, j44.9
• a patient with chronic DVT in the lower leg requires heparin to maintain therapeutic
anticoagulation levels. he has regular PTTs drawn to monitor his level of anticoagulation
-✓✓ i82.5z1, z79.01
• ch. 3, question 5
diagnosis with severe exacerbation of chi, poorly controlled hon, and worsening ckd and
acute renal failure -✓✓ i13.0, i50.9, n17.9, n18.9
• a patient suffering an abdominal aortic aneurysm involving the renal undergoes
endovascular repair deploying a fenestrated visceral autograft using 2 visceral artery
endoprostheses -✓✓ i71.4, i72.2
• a patient with cod, stage 5 is evaluated by the provider and receives peritoneal
dialysis. the provider evaluates the patient once before dialysis begins -✓✓ n18.6, z99.2
• ch. 3 question 8
CORRECT Answers | A+ Verified | 2026
which medicare part is reimbursed based on the risk adjustment models -✓✓ part c
• who typically employs risk adjustment coders -✓✓ health plans
• is a health plan required to follow the minimum necessary rule -✓✓ yes, health plans
are covered entities and are therefore required to follow the minimum necessary rule
• what is an example of fraud -✓✓ reporting a diagnosis or co-morbidity that does not
exist to obtain higher reimbursement
• which part of medicare is also called medicare advantage -✓✓ part c
• which health insurance assistance program is sponsored by federal and state
governments -✓✓ medicaid
• what OIG document should a medicare advantage participant review for potential
problem areas that will receive special scrutiny in the upcoming year -✓✓ OIG work plan
• which code set is used by risk adjustment coders -✓✓ icd-10-cm
• which regulation strengthens HIPAA rules by addressing privacy and security
concerns associated with the electronic transmission of health information -✓✓ Health
Information Technology for Economic and Clinical Health Act (HITECH)
• what is coding -✓✓ translating a written or dictated medical record into a series of
alphanumeric codes
• which organ is in the thoracic cavity -✓✓ lungs
• what does the term distal indicate -✓✓ farther from the point of attachment
• blood is received back into the left atrium of the heart through.... -✓✓ pulmonary veins
• the root of the nail is also known as what -✓✓ germinal matrix
• the documentation states: Past Surgical history: she had a lumpectomy of the breast
for DCIS 12 years ago which successfully eradicated the CA
how would this be reported -✓✓ personal history of breast cancer
, • the documentation states: soft druse, some calcified
what system would have this documentation -✓✓ ocular
• which organ does pulmonary refer to -✓✓ lungs
• what is a PEG tube -✓✓ a tube inserted into the stomach for long term feeding
• angina pectoris refers to which system -✓✓ cardiovascular
• what is cholelithiasis -✓✓ stones in the gallbladder
• a patient with diabetes type 2 presents with ED. after examination, the provider
diagnosis the patient with ED due to diabetic autonomic neuropathy. -✓✓ e11.43, n52.1
• a patient is transported from the nursing home for facial drooping, slurred speech, and
dizziness. the patient was admitted for testing. after an MRI, the provider diagnosed the
patient with a TIA -✓✓ g45.9
• the physician was called to the hospital floor for the medical management of a patient
admitted one day ago with a reduced oxygen level due to aspiration pneumonia and
COPD. no chest pain at present, but still SOB and some swelling in his lower
extremities. patient was tachypneic yesterday; lungs reveal course crackles in both
bases, right worse than left. the physician writes instructions to continue with
intravenous antibiotic treatment and respiratory support with ventilator management. he
reviewed the chest X-ray which shows gastric contents in the lungs and labs. patient is
improving and a pulmonary consultation has been requested -✓✓ j69.0, t17.810a, j44.9
• a patient with chronic DVT in the lower leg requires heparin to maintain therapeutic
anticoagulation levels. he has regular PTTs drawn to monitor his level of anticoagulation
-✓✓ i82.5z1, z79.01
• ch. 3, question 5
diagnosis with severe exacerbation of chi, poorly controlled hon, and worsening ckd and
acute renal failure -✓✓ i13.0, i50.9, n17.9, n18.9
• a patient suffering an abdominal aortic aneurysm involving the renal undergoes
endovascular repair deploying a fenestrated visceral autograft using 2 visceral artery
endoprostheses -✓✓ i71.4, i72.2
• a patient with cod, stage 5 is evaluated by the provider and receives peritoneal
dialysis. the provider evaluates the patient once before dialysis begins -✓✓ n18.6, z99.2
• ch. 3 question 8
