2022 CRC Exam Questions and answers, 100% Accurate, graded A+

2022 CRC Exam Questions and answers, 100% Accurate, graded A+ Which coding manuals do outpatient coders focus on learning? CPT, HCPCS Level II, ICD-10-CM What year did HIPAA become law? 1996 How many components are included in an effective compliance plan? 7 What is the value of remittance advice? It states what will be paid and why any changes to charges were made Which one of the following is NOT allowable for coding in the outpatient setting? Consistent with Use of the up and down arrows ICD code instead of a written description What ICD-10-CM code(s) should be reported for COPD with acute bronchitis? J44.0, J20.9 In ICD-10-CM, when can hemiparesis be coded? Documentation states hemiparesis Weakness on one side of the body due to stroke/CVA What is the Joint Commission rule concerning entries in the medical record? Medical record needs to be signed, dated, and timed The suffix of a drug's generic name identifies which of the following: a. Action of the drug b. Active chemical substances c. Class of the drug d. Therapeutic purpose of the drug Class of the drug The drug stem -vir indicates the drug belongs to which of the following classes: a. Antiviral drug b. Proton Pump Inhibitor c. Monoclonal antibodies d. ACE inhibitor Antiviral drug The drug stem -barb indicates the drug belongs to which of the following classes: a. Antidepressant b. Barbiturates c. Humanized monoclonal antibody d. ACE Inhibitor Barbiturates The drug stem -oxetine indicates the drug belongs to which of the following classes: a. Antidepressant related to fluoxetine b. Barbiturates c. Humanized monoclonal antibody d. ACE Inhibitor Antidepressant related to fluoxetine The drug stem -zumab indicates the drug belongs to which of the following classes: a. Humanized monoclonal antibody b. Monoclonal antibodies c. Chimeric antibody that responds to d. Tyrosine-kinase Inhibitor more than one antigen Humanized monoclonal antibody The drug stem -olol indicates the drug belongs to which of the following classes a. Quinolone-derived antibiotics b. Dopamine and serotonin–norepinephrine reuptake inhibitor c. Beta blocker d. Tyrosine-kinase Inhibitor Beta blocker Which of the following is NOT considered a side effect of sulphonylurea drugs? a. Increase appetite b. Weight loss c. Decreased appetite d. Both B & C Decreased appetite Weight loss Which of the following antianginal drugs reduce the work of the heart? a. Nitrostat b. Metoprolol c. Verapamil d. Diltiazem Metoprolol Anticoagulants prevent clotting by blocking the effects of: Vitamin K Which of the following drugs is used primarily to treat hypertension and congestive heart failure? a. Angiotensin receptor antagonists b. Anticholinergics c. Proton-pump inhibitor d. ACE Inhibitors ACE inhibitors Which of the following drugs is NOT classified as a disease-modifying antirheumatic drugs (DMARDs)? Methotrexate Cyclosporin Infliximab Rituximab All are DMARDS DMARDs reduce the level of: Tumor necrosis factor alpha (TNF-alpha) Which of the following drugs is used to slow the progression of uterine cancer? Megestrol Progesterone Estrogen Oxytocin Megestrol The drug, Trastuzumab, belongs to which of the following drug classes? a. Humanized monoclonal antibody b. Antibiotic c. ACE inhibitors d. Proton-pump inhibitor Humanized monoclonal antibody Tamoxifen, a drug used to slow the progression of certain types of breast cancer, does so by blocking the action of which of the following hormones on breast cells? a. Megestrol b. Progesterone c. Estrogen d. Oxytocin Estrogen In the CDPS risk adjustment model, what category do heart attacks fall under? Medium Which of the following is TRUE regarding the risk adjustment model by HHS? a. States are mandated to use the Medicare HCCs b. States can either use the federal methodology or propose an alternate for certification by HHS. c. States can either use the federal methodology or exclude risk adjustment logic from reimbursement. d. States can determine their own policy for payment without a risk adjustment component. States can either use the federal methodology or propose an alternate for certification by HHS Which elements are considered in the Medicare HCC model? I. Age II. Disability status III. Conditions that affect the long-term treatment of the patient IV. All acute conditions V. Insurance Status I, II, III, and V only age, disability status, conditions that affect the long-term treatment of the patient, insurance status What is the purpose of the coding intensity adjustment? Determine different coding patterns in HCC compared to inpatient claims covered by Part A. Determine different coding patterns in HCC compared to outpatient claims covered by Part B. How often is the normalization factor adjusted? Yearly Under the Health and Human Services (HHS) Hierarchical Condition Category model, which of the below plans has the highest out of pocket expense once the premium is paid? Bronze Which statement is TRUE regarding the Coding Intensity Adjustment? MA plan risk scores increase faster than FFS scores In the CMS Star Ratings program, which measure is given the highest weight? Outcomes Which of the following are domains in CMS Part C & D Stars Rating? I. Staying healthy II. Managing chronic conditions III. Member experience with health plans IV. Member complaints and changes in the health plan's performance V. Health plan customer service I, II, III, IV, and V · Staying Healthy: Screenings, Tests and Vaccines · Managing Chronic (Long Term) Conditions · Member Experience with Health Plan · Member Complaints and Changes in the Health Plan's Performance · Health Plan Customer Service · Drug Plan Customer Service · Member Complaints and Changes in the Drug Plan's Performance · Member Experience with the Drug Plan · Drug Safety and the Accuracy of Drug Pricing How often are HEDIS measures revised? Annually How is HEDIS data collected? I. Surveys II. Medical chart reviews III. Insurance Claims I, II, and III surveys, medical chart reviews, and insurance claims from hospitalizations, medical office visits, and procedures Predictive modeling can use many data elements. Which are beneficial for identifying a person with diabetes? I. Rx claims II. Medical claims III. DME claims I, II, and III Rx claims, medical claims, and DME claims If you were using predictive modeling and the results were: - Rx Claim: Evista (estrogen agonists, hormone therapy) - Medical Claims: Pelvic fracture and DXA scan (bone density test) What diagnosis would you predict this member has? Osteoporosis Which of the following is considered acceptable documentation for a RADV audit? a. Documentation from a face-to-face encounter with an acceptable provider type. b. Diagnostic radiology records. c. Labs and diagnostic reports that have not been interpreted. d. Superbills or encounter forms. Documentation from a face-to-face encounter with an acceptable provider Muscle is attached to bone by what method? Tendons, aponeurosis, and directly to bone What is a myocardial infarction? Lack of oxygen to the heart tissue, resulting in tissue death Which chamber of the heart is considered the one working the hardest? Left ventricle The loop of Henle is located in which structure? Kidney The term episiotomy best describes a procedure of what type? An incision made in the perineum to enlarge the passage for the fetus during delivery Which part of the brain controls blood pressure, heart rate, and respiration? Medulla Which of the following is true about the tympanic membrane? a. It separates the middle ear from the inner ear b. It separates the external ear from the middle ear c. It sits within the middle ear d. It sits within the inner ear It separates the external ear from the middle ear Impetigo is best described as A bacterial skin infection Which of the following characterizes the disorder dystonia? a. Difficulty swallowing b. Abnormal muscle tone causing abnormal postures and muscle spasm c. Impairment of speech d. Slowness of motion