AAPC CRC Practice Test 2 Questions &
Answers
1.How many charts can be submitted to CMS to validate an HCC?
A. One
B. Three
C. Two
D. Five
ANS: D. Five
2.The results of a RADV audit are extrapolated across all members of the
plan that was audited. What does this mean?
A. Financial penalties will be limited to each specific member
B. Financial penalties will be averaged over the plan membership
C. Financial penalties will be imposed across the plan membership
D. Financial penalties will not be imposed until two years post audit
ANS: C. Finan- cial penalties will be imposed across the plan
membership
3.Retrospective audits generally include finding additional diagnoses. CMS
has stated that the deletion of conditions needs to be part of these audits.
What might happen when a health plan deletes unsupported diagnoses that
were submitted on a claim?
I. There is a potential of loss of revenue
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,II. Billing compliance issues might come too light
III. All companies follow CMS directives
A. I and II
B. I
C. I and III
D. III
ANS: A. I and II
4.Which one of the following would prevent a chart from being coded
for Medicare risk adjustment?
A. Patient's DOB is not documented on the medical record
B. The patient presented for an acute condition
C. Medical record does not include the credentials of the treating provider
D. Date of service is past 90 days
ANS: C. Medical record does not include the credentials of the
treating provider
5.Which diagnoses can be coded from a medical record that states a
member has the condition, but does not contain supporting documentation?
I. COPD
II. Croup
III. A-Fib
IV. GERD
V. Parkinson's disease
VI. MS
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, A. I and II
B. III, IV, V and VI
C. II, V and VI
D. I, III, V, and VI
ANS: D. I, III, V, and VI
6.RADV/IVA audit submissions typically require:
I. Provider printed name
II. Two patient identifiers
III. Provider's signature
IV. Must include specialist consultationsV. Must include coordination of
care documentation by clinical staff
A. II and III
B. I, II and IV
C. I, III, IV, and V
D. I, II, III, IV, and V
ANS: A. II and III
7.Which statements are TRUE regarding retrospective audits?
I. Can be performed by internal employees
II. Can be performed by external consultants who sign a business agreement
III. Performed prior to data being submitted
IV. Performed after data was submitted
A. I and III
B. I and IV
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Answers
1.How many charts can be submitted to CMS to validate an HCC?
A. One
B. Three
C. Two
D. Five
ANS: D. Five
2.The results of a RADV audit are extrapolated across all members of the
plan that was audited. What does this mean?
A. Financial penalties will be limited to each specific member
B. Financial penalties will be averaged over the plan membership
C. Financial penalties will be imposed across the plan membership
D. Financial penalties will not be imposed until two years post audit
ANS: C. Finan- cial penalties will be imposed across the plan
membership
3.Retrospective audits generally include finding additional diagnoses. CMS
has stated that the deletion of conditions needs to be part of these audits.
What might happen when a health plan deletes unsupported diagnoses that
were submitted on a claim?
I. There is a potential of loss of revenue
1/
18
,II. Billing compliance issues might come too light
III. All companies follow CMS directives
A. I and II
B. I
C. I and III
D. III
ANS: A. I and II
4.Which one of the following would prevent a chart from being coded
for Medicare risk adjustment?
A. Patient's DOB is not documented on the medical record
B. The patient presented for an acute condition
C. Medical record does not include the credentials of the treating provider
D. Date of service is past 90 days
ANS: C. Medical record does not include the credentials of the
treating provider
5.Which diagnoses can be coded from a medical record that states a
member has the condition, but does not contain supporting documentation?
I. COPD
II. Croup
III. A-Fib
IV. GERD
V. Parkinson's disease
VI. MS
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18
, A. I and II
B. III, IV, V and VI
C. II, V and VI
D. I, III, V, and VI
ANS: D. I, III, V, and VI
6.RADV/IVA audit submissions typically require:
I. Provider printed name
II. Two patient identifiers
III. Provider's signature
IV. Must include specialist consultationsV. Must include coordination of
care documentation by clinical staff
A. II and III
B. I, II and IV
C. I, III, IV, and V
D. I, II, III, IV, and V
ANS: A. II and III
7.Which statements are TRUE regarding retrospective audits?
I. Can be performed by internal employees
II. Can be performed by external consultants who sign a business agreement
III. Performed prior to data being submitted
IV. Performed after data was submitted
A. I and III
B. I and IV
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18
