Question 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
CORRECT ANSWER
A. I and II
Question 2
The definition of a best medical record for a RADV audit is:
A. Documentation validates the CMS requested HCCs, contains all the necessary
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
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,D. Documentation that validates the requested HCC plus validates an additional 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
CORRECT ANSWER
A. Documentation validates the CMS requested HCCs, contains all the necessary
documentation elements and has an additional HCC not requested by CMS
Question 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
CORRECT ANSWER
C. I and IV
Question 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
CORRECT ANSWER
B. Cardiologist records
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, Question 5
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS
CORRECT ANSWER
D. I, II and III
Question 6
Which type of audit evaluates appropriate risk scores of patients?
A. ZPIC
B. RADV
C. RAC
D. CERT
CORRECT ANSWER
B. RADV
Question 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
CORRECT ANSWER
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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
CORRECT ANSWER
A. I and II
Question 2
The definition of a best medical record for a RADV audit is:
A. Documentation validates the CMS requested HCCs, contains all the necessary
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
1
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,D. Documentation that validates the requested HCC plus validates an additional 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
CORRECT ANSWER
A. Documentation validates the CMS requested HCCs, contains all the necessary
documentation elements and has an additional HCC not requested by CMS
Question 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
CORRECT ANSWER
C. I and IV
Question 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
CORRECT ANSWER
B. Cardiologist records
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, Question 5
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS
CORRECT ANSWER
D. I, II and III
Question 6
Which type of audit evaluates appropriate risk scores of patients?
A. ZPIC
B. RADV
C. RAC
D. CERT
CORRECT ANSWER
B. RADV
Question 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
CORRECT ANSWER
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