CRC Practice Exam A 2023 with 100% correct answers

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 A Anastrozole is used to treat breast cancer in women who have gone through menopause. It works by lowering estrogen hormone levels to help shrink tumors and slow their growth. Tamoxifen is prescribed for women who have breast cancer with tumors fueled by estrogen. The medication blocks the action of estrogen. 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 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 A RADV guidelines state that the Best Medical Record contains documentation that supports HCC and all elements of proper documentation are followed, for example, signed by provider. Proper documentation is the first aspect that must be reviewed to determine if the record could be considered a Best Medical Record. After proper documentation is determined, the additional HCC (which can decrease the amount owed to CMS) within the note makes this the Best Medical Record. 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 A. I B. II and III C. I and IV D. I, II, III and IV C Providers must report all diagnoses that affect the patient's evaluation, care, and treatment, including: Nature of the presenting problem All chronic conditions (such as atrial fibrillation, congestive heart failure (CHF), chronic kidney disease (CKD), rheumatoid arthritis, diabetes with manifestations, chronic obstruction pulmonary disease (COPD), all active cancers) History on any relevant past conditions ZV-codes (factors that influence health/status codes) E-codes (external causes of injury and poisoning, and certain other consequences of external causes) HCC scores on individual members determine CMS reimbursement to the plan. Diagnosis and demographic information should be captured at each face-to-face encounter to obtain a health-based measure of that member's future medical needs. 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 B A cardiologist is the only approved provider provided as an answer option according to CMS for Risk Adjustment Retrospective audits should include the following attributes: I. Provider signatures II. Supporting documentation of the patient's diagnoses III. DOS A. I B. II C. I and II D. I, II and III D