AAPC CRC study guide 2023 questions and 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. I and II 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. Documentation validates the CMS requested HCCs, contains all the necessary documentation elements and has an additional HCC not requested by CMS 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 C. I and IV 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. Cardiologist records Retrospective audits should include the following attributes: I. Provider signatures II. Supporting documentation of the patient's diagnoses III. DOS D. I, II and III Which type of audit evaluates appropriate risk scores of patients? A. ZPIC B. RADV C. RAC D. CERT B. RADV 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 C. A single DOS for outpatient records and the full inpatient set for hospital records What is TRUE regarding the code assignment requirement for chronic kidney 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. C. The patient should be diagnosed with CKD and is on chronic dialysis or receiving kidney transplants are associated with this diagnosis. 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 "dependency" can be implied D. No, the surgeon did not document that Joey was dependent on the Oxycodone D. No, the surgeon did not document that Joey was dependent on the Oxycodone 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, must be assessed and documented in order for payment adjustments to be received. How often should a provider see and assess a patient in a calendar year to validate amputation status? A. Twice a year B. Once a year C. Four times a year D. Every two years B. Once a year