CRC Exam Prep with all Correct & 100% Verified
Answers |Already Graded A+
Which statement describes a medically necessary service? ✔Correct Answer-Using the least radical
service/procedure that allows for effective treatment of the patient's complaint or condition.
Rationale: Medical necessity is using the least radical services/procedure that allows for effective
treatment of the patient's complaint or condition.
Which code set does risk adjustment coding focus on? ✔Correct Answer-ICD-10-CM
Rationale: Risk adjustment coding focuses on diagnosis coding using the ICD-10-CM code set. Risk
adjustment diagnoses are pulled from claims data and medical record documentation in all settings.
Risk adjustment coders can work for health plans, providers, or other healthcare entities.
Which statement is FALSE regarding Mid-level Providers? ✔Correct Answer-PAs are reimbursed at
an equal or higher rate than a physician.
Rationale: PAs are reimbursed at a lower rate than a physician.
Risk Adjustment Coders should have knowledge in which of the following? ✔Correct Answer-
Medications and diagnostic testing
Rationale: Risk Adjustment Coders should have knowledge in the use of medications, treatments of
the patient, and diagnostic testing.
Which Insurance is the primary government payer in the United States? ✔Correct Answer-
Medicare
Rationale: Medicare is the primary government payer in the United States. Medicare is a federal
health insurance program, administered by CMS, that provides coverage for people 65 and older,
blind, or disabled, and people with permanent kidney failure or end-stage renal disease (ESRD).
Who would NOT be considered a covered entity under HIPAA? ✔Correct Answer-Patients
Rationale: Covered entities in relation to HIPAA include healthcare providers, health plans, and
healthcare clearinghouses. The patient is not considered a covered entity although it is the patient's
data that is protected.
Under HIPAA, what would be a policy requirement for minimum necessary? ✔Correct Answer-Only
individuals whose job requires it may have access to protected health information.
Rationale: It is the responsibility of a covered entity to develop and implement policies best suited to
its circumstances to meet HIPAA requirements. As a policy requirement, only those individuals whose
job requires it may have access to protected health information.
Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and
affected privacy and security? ✔Correct Answer-HITECH
Answers |Already Graded A+
Which statement describes a medically necessary service? ✔Correct Answer-Using the least radical
service/procedure that allows for effective treatment of the patient's complaint or condition.
Rationale: Medical necessity is using the least radical services/procedure that allows for effective
treatment of the patient's complaint or condition.
Which code set does risk adjustment coding focus on? ✔Correct Answer-ICD-10-CM
Rationale: Risk adjustment coding focuses on diagnosis coding using the ICD-10-CM code set. Risk
adjustment diagnoses are pulled from claims data and medical record documentation in all settings.
Risk adjustment coders can work for health plans, providers, or other healthcare entities.
Which statement is FALSE regarding Mid-level Providers? ✔Correct Answer-PAs are reimbursed at
an equal or higher rate than a physician.
Rationale: PAs are reimbursed at a lower rate than a physician.
Risk Adjustment Coders should have knowledge in which of the following? ✔Correct Answer-
Medications and diagnostic testing
Rationale: Risk Adjustment Coders should have knowledge in the use of medications, treatments of
the patient, and diagnostic testing.
Which Insurance is the primary government payer in the United States? ✔Correct Answer-
Medicare
Rationale: Medicare is the primary government payer in the United States. Medicare is a federal
health insurance program, administered by CMS, that provides coverage for people 65 and older,
blind, or disabled, and people with permanent kidney failure or end-stage renal disease (ESRD).
Who would NOT be considered a covered entity under HIPAA? ✔Correct Answer-Patients
Rationale: Covered entities in relation to HIPAA include healthcare providers, health plans, and
healthcare clearinghouses. The patient is not considered a covered entity although it is the patient's
data that is protected.
Under HIPAA, what would be a policy requirement for minimum necessary? ✔Correct Answer-Only
individuals whose job requires it may have access to protected health information.
Rationale: It is the responsibility of a covered entity to develop and implement policies best suited to
its circumstances to meet HIPAA requirements. As a policy requirement, only those individuals whose
job requires it may have access to protected health information.
Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and
affected privacy and security? ✔Correct Answer-HITECH
