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Aapc Crc Complete Risk Adjustment Coder Study Guide

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AAPC CRC Study Guide is a healthcare coding resource for learners preparing for the Certified Risk Adjustment Coder (CRC) certification. It may cover risk adjustment principles, ICD-10-CM coding, hierarchical condition categories (HCCs), medical terminology, anatomy, clinical documentation, and coding guidelines. It supports review of how documented diagnoses relate to risk adjustment and reimbursement.

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AAPC CRC study guide


Question 1.
which medicare part is reimbursed based on the risk adjustment models

ANSWER
part c



Question 2.
who typically employs risk adjustment coders

ANSWER
health plans



Question 3.
is a health plan required to follow the minimum necessary rule

ANSWER
yes, health plans are covered entities and are therefore required to follow the minimum necessary rule



Question 4.
what is an example of fraud

ANSWER
reporting a diagnosis or co-morbidity that does not exist to obtain higher re-imbursement



Question 5.
which part of medicare is also called medicare advantage

ANSWER
part c



Question 6.
which health insurance assistance program is sponsored by federal and state governments

ANSWER
medicaid



Question 7.
what OIG document should a medicare advantage participant review for potential problem areas that will receive special scrutiny in
the upcoming year

ANSWER
OIG work plan






, Question 8.
which code set is used by risk adjustment coders

ANSWER
icd-10-cm



Question 9.
which regulation strengthens HIPAA rules by addressing privacy and security concerns associated with the electronic transmission of
health information

ANSWER
Health Information Technology for Economic and Clinical Health Act (HITECH)



Question 10.
what is coding

ANSWER
translating a written or dictated medical record into a series of alphanumeric codes



Question 11.
which organ is in the thoracic cavity

ANSWER
lungs



Question 12.
what does the term distal indicate

ANSWER
farther from the point of attachment



Question 13.
blood is received back into the left atrium of the heart through....

ANSWER
pulmonary veins



Question 14.
the root of the nail is also known as what

ANSWER
germinal matrix






, Question 15.
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

ANSWER
personal history of breast cancer



Question 16.
the documentation states: soft druse, some calcified what system would have this documentation

ANSWER
ocular



Question 17.
which organ does pulmonary refer to

ANSWER
lungs



Question 18.
what is a PEG tube

ANSWER
a tube inserted into the stomach for long term feeding



Question 19.
angina pectoris refers to which system

ANSWER
cardiovascular



Question 20.
what is cholelithiasis

ANSWER
stones in the gallbladder



Question 21.
a patient with diabetes type 2 presents with ED. after examination, the provider diagnosis the patient with ED due to diabetic
autonomic neuropathy.

ANSWER
e11.43, n52.1

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