AAPC CRC TEST 1 QUESTIONS AND ANSWERS
1.Which of the following medications are prescribed to cancer patients
to eradicate the cancer or for prophylaxis?
I. Tamoxifen
II. Anastrozole
III. Januvia
IV. Crestor
A. I and II
B. I and III
C. II and III
D. I, II, III and IV
ANS: A. I and II
2.The definition of a best medical record for a RADV audit is:
A. Documentation validates the CMS requested HCCs, contains all the
neces- sary documentation elements and has an additional HCC not
requested by CMS
B. Documentation that validates all the requested HCCs
C. Documentation that validates the requested HCC, but there is no
provider signature
D. Documentation that validates the requested HCC plus validates an
addition- al HCC, contains all the necessary documentation elements, but is
missing the provider signature, for which a signed CMS attestation was
,provided but not signed by the provider
ANS: A. Documentation validates the CMS requested HCCs, contains all
the necessary documentation elements and has an additional HCC not
requested by CMS
3.Which of the following are reported by a provider for beneficiaries in
a Medicare Advantage Plan?
I. Nature of the presenting problem
II. Resolved conditions that have been treated in the past
III. Family history for all conditions
IV. All chronic conditions
ANS: C. I and IV
4.Which of the following records would be a good source for a
retrospective chart audit?
A. DME documentation
B. Cardiologist records
C. Dietician notes
D. RN notes
ANS: B. Cardiologist records
5.Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS
, ANS: D. I, II and III
6.Which type of audit evaluates appropriate risk scores of patients?
A. ZPIC
B. RADV
C. RAC
D. CERT
ANS: B. RADV
7.What information is required when submitting documentation to support a
diagnosis for a RADV/IVA?
A. All patient records for the calendar year resulting in care for a
chronic condition
B. All inpatient hospital records where a readmission occurred
C. A single DOS for outpatient records and the full inpatient set for
hospital records
D. All professional provider documentation for the previous year
ANS: C. A single DOS for outpatient records and the full inpatient set
for hospital records
8.What is TRUE regarding the code assignment requirement for chronic
kid- ney disease requiring dialysis (N18.6)?
A. The diagnosis should only be reported when the patient is admitted to
the hospital.
B. The diagnosis should only be reported when the patient is diagnosed
, with CKD and is actively being treated by a specialist.
C. The patient should be diagnosed with CKD and is on chronic dialysis
or receiving kidney transplants are associated with this diagnosis.
D. The diagnosis should only be reported when the patient is diagnosed with
chronic renal insufficiency.
ANS: C. The patient should be diagnosed with CKD and is on chronic
dialysis or receiving kidney transplants are associated with this
diagnosis.
9.Joey is prescribed Oxycodone for a back injury by his orthopedic surgeon
two years ago. The surgeon documents he would like to try another
medication to dull the pain. Joey attempts to change to the newer
medication but there is breakthrough pain and he goes back to the
Oxycodone. Would code from category F11.2 be appropriate?
A. Yes, Joey has been on the Oxycodone for two years
B. Yes, Joey's pain could not be controlled by the second medication
C. No, a person must be on a medication a minimal of 3 years before
"depen- dency" can be implied
D. No, the surgeon did not document that Joey was dependent on the
Oxy- codone
ANS: D. No, the surgeon did not document that Joey was dependent
on the Oxycodone
10.Diagnoses must be based on face-to face encounters between members
and an MD, PA, or NP and status conditions like a below knee amputation,
1.Which of the following medications are prescribed to cancer patients
to eradicate the cancer or for prophylaxis?
I. Tamoxifen
II. Anastrozole
III. Januvia
IV. Crestor
A. I and II
B. I and III
C. II and III
D. I, II, III and IV
ANS: A. I and II
2.The definition of a best medical record for a RADV audit is:
A. Documentation validates the CMS requested HCCs, contains all the
neces- sary documentation elements and has an additional HCC not
requested by CMS
B. Documentation that validates all the requested HCCs
C. Documentation that validates the requested HCC, but there is no
provider signature
D. Documentation that validates the requested HCC plus validates an
addition- al HCC, contains all the necessary documentation elements, but is
missing the provider signature, for which a signed CMS attestation was
,provided but not signed by the provider
ANS: A. Documentation validates the CMS requested HCCs, contains all
the necessary documentation elements and has an additional HCC not
requested by CMS
3.Which of the following are reported by a provider for beneficiaries in
a Medicare Advantage Plan?
I. Nature of the presenting problem
II. Resolved conditions that have been treated in the past
III. Family history for all conditions
IV. All chronic conditions
ANS: C. I and IV
4.Which of the following records would be a good source for a
retrospective chart audit?
A. DME documentation
B. Cardiologist records
C. Dietician notes
D. RN notes
ANS: B. Cardiologist records
5.Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS
, ANS: D. I, II and III
6.Which type of audit evaluates appropriate risk scores of patients?
A. ZPIC
B. RADV
C. RAC
D. CERT
ANS: B. RADV
7.What information is required when submitting documentation to support a
diagnosis for a RADV/IVA?
A. All patient records for the calendar year resulting in care for a
chronic condition
B. All inpatient hospital records where a readmission occurred
C. A single DOS for outpatient records and the full inpatient set for
hospital records
D. All professional provider documentation for the previous year
ANS: C. A single DOS for outpatient records and the full inpatient set
for hospital records
8.What is TRUE regarding the code assignment requirement for chronic
kid- ney disease requiring dialysis (N18.6)?
A. The diagnosis should only be reported when the patient is admitted to
the hospital.
B. The diagnosis should only be reported when the patient is diagnosed
, with CKD and is actively being treated by a specialist.
C. The patient should be diagnosed with CKD and is on chronic dialysis
or receiving kidney transplants are associated with this diagnosis.
D. The diagnosis should only be reported when the patient is diagnosed with
chronic renal insufficiency.
ANS: C. The patient should be diagnosed with CKD and is on chronic
dialysis or receiving kidney transplants are associated with this
diagnosis.
9.Joey is prescribed Oxycodone for a back injury by his orthopedic surgeon
two years ago. The surgeon documents he would like to try another
medication to dull the pain. Joey attempts to change to the newer
medication but there is breakthrough pain and he goes back to the
Oxycodone. Would code from category F11.2 be appropriate?
A. Yes, Joey has been on the Oxycodone for two years
B. Yes, Joey's pain could not be controlled by the second medication
C. No, a person must be on a medication a minimal of 3 years before
"depen- dency" can be implied
D. No, the surgeon did not document that Joey was dependent on the
Oxy- codone
ANS: D. No, the surgeon did not document that Joey was dependent
on the Oxycodone
10.Diagnoses must be based on face-to face encounters between members
and an MD, PA, or NP and status conditions like a below knee amputation,
