Certified Risk Adjustment- AAPC EXAM
QUESTIONS AND VERIFIED CORRECT
ANSWERS LATEST 2026-2027 NEW VERSION
Is a health plan required to follow the minimum necessary rule?
A. Yes, health plans are covered entities and are required to follow the rule
B. Yes, health plans are not covered entities but as business associates are required
to follow the rule
C. No, health plans are not covered entities and are not required to follow the rule
D. No, health plans are covered entities but are not requried to follow the rule -
answer>>>A. Health plans are covered entities and are required to follow the
minimum necessary rule
Which Medicare Part is Reimbursed based on the risk adjustment models?
A. Part A
B. Part B
C. Part C
D. Part D - answer>>>C. Part C
Who typically employs risk adjustment coders?
A.Physician offices
B. Hospitals
C. Ambulatory surgical centers
D. Health plans - answer>>>D. Health Plans
Which examples is considered fraud?
A. Reporting a diagnosis or co-morbidity that does not exist to obtain higher
reimbursement
B. Reporting an additional diagnosis for a patient that is documented in the medical
record
, -
C. Reporting a diagnosis that only relates to documentation
D. Reporting additional diagnoses that affect the care of the patient. - answer>>>A.
Reporting a diagnosis or co-morbidity to obtain a higher reimbursement
Which part of Medicare is also called Medicare Advantage?
A. Part A
B. Bart B
C. Part C
D. Part D - answer>>>C. Part C this combines the benefits from Medicare A, B and
sometimes D.
Which Health insurance assistance program is sponsored by federal and state
governments?
A. Medicare
B. Medicaid
C. Commercial Carriers
D. Private payers - answer>>>B. Medicaid
What OIG Document should a Medicare Advantage participant review for potential
problem areas that will receive special scrutiny in the upcoming year?
A. Compliance program Guideance
B. Safe Harbor Regulations
C. Red Flag Rules
D. OIG Work Plan - answer>>>D. OIG Work plan
Which code set is used by risk adjustment coders?
A.CPT
B. ICD-10-CM
C. ICD-10-PCS
, D. HCPCS LEVEL II - answer>>>B. ICD-10-CM
Which regulation strengthens HIPAA rules by addressing privacy and security
concerns associated with the electronic transmission of health information?
A. Social Security Act (SSA)
B. Deficit Reduction Act (DRA)
C. Health Information Techology for Economic and Clinical Health Act (HITECH)
D. Medicare Access and CHIP Reauthorization Act (MACRA) - answer>>>C. Health
Information Technology for Economic and Clinical Health Act (HITECH)
What is coding?
A. Running data reports to pull diagnostic codes reported
B. Translating written or dictated medical records into a series of alphanumeric
codes
C. Creating an electronic file for transmission
D. Creating process to follow within the health plan - answer>>>B. Translating
written or dictated medical records into a series of alphanumeric codes
What Organ is in the Thoracic Cavity?
A. Gallbladder
B. Kidneys
C. Spleen
D. Lungs - answer>>>D. Lungs
What does the term distal indicate?
A. Front or toward the front
B. Farther from the point of attachment
C. Nearer to the point of attachment
D. Posterior or toward the back - answer>>>B. Farther from the point of attachment
Blood is received back into the left atrium of the heart through:
QUESTIONS AND VERIFIED CORRECT
ANSWERS LATEST 2026-2027 NEW VERSION
Is a health plan required to follow the minimum necessary rule?
A. Yes, health plans are covered entities and are required to follow the rule
B. Yes, health plans are not covered entities but as business associates are required
to follow the rule
C. No, health plans are not covered entities and are not required to follow the rule
D. No, health plans are covered entities but are not requried to follow the rule -
answer>>>A. Health plans are covered entities and are required to follow the
minimum necessary rule
Which Medicare Part is Reimbursed based on the risk adjustment models?
A. Part A
B. Part B
C. Part C
D. Part D - answer>>>C. Part C
Who typically employs risk adjustment coders?
A.Physician offices
B. Hospitals
C. Ambulatory surgical centers
D. Health plans - answer>>>D. Health Plans
Which examples is considered fraud?
A. Reporting a diagnosis or co-morbidity that does not exist to obtain higher
reimbursement
B. Reporting an additional diagnosis for a patient that is documented in the medical
record
, -
C. Reporting a diagnosis that only relates to documentation
D. Reporting additional diagnoses that affect the care of the patient. - answer>>>A.
Reporting a diagnosis or co-morbidity to obtain a higher reimbursement
Which part of Medicare is also called Medicare Advantage?
A. Part A
B. Bart B
C. Part C
D. Part D - answer>>>C. Part C this combines the benefits from Medicare A, B and
sometimes D.
Which Health insurance assistance program is sponsored by federal and state
governments?
A. Medicare
B. Medicaid
C. Commercial Carriers
D. Private payers - answer>>>B. Medicaid
What OIG Document should a Medicare Advantage participant review for potential
problem areas that will receive special scrutiny in the upcoming year?
A. Compliance program Guideance
B. Safe Harbor Regulations
C. Red Flag Rules
D. OIG Work Plan - answer>>>D. OIG Work plan
Which code set is used by risk adjustment coders?
A.CPT
B. ICD-10-CM
C. ICD-10-PCS
, D. HCPCS LEVEL II - answer>>>B. ICD-10-CM
Which regulation strengthens HIPAA rules by addressing privacy and security
concerns associated with the electronic transmission of health information?
A. Social Security Act (SSA)
B. Deficit Reduction Act (DRA)
C. Health Information Techology for Economic and Clinical Health Act (HITECH)
D. Medicare Access and CHIP Reauthorization Act (MACRA) - answer>>>C. Health
Information Technology for Economic and Clinical Health Act (HITECH)
What is coding?
A. Running data reports to pull diagnostic codes reported
B. Translating written or dictated medical records into a series of alphanumeric
codes
C. Creating an electronic file for transmission
D. Creating process to follow within the health plan - answer>>>B. Translating
written or dictated medical records into a series of alphanumeric codes
What Organ is in the Thoracic Cavity?
A. Gallbladder
B. Kidneys
C. Spleen
D. Lungs - answer>>>D. Lungs
What does the term distal indicate?
A. Front or toward the front
B. Farther from the point of attachment
C. Nearer to the point of attachment
D. Posterior or toward the back - answer>>>B. Farther from the point of attachment
Blood is received back into the left atrium of the heart through:
