CRC MOCK EXAM NEWEST 2026/ 2027 ACTUAL EXAM
TEST BANK| AAPC CERTIFIED RISK ADJUSTMENT
CODER (CRC) CERTIFICATION EXAM REVIEW WITH
300 REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS/ GRADED A+ (MOST RECENT!!)
_______ are a type of episodic care payment plan used by Medicare to
pay for treatments and services provided to beneficiaries who have been
admitted into an acute care hospital.
A. APCs
B. DRGs
C. POSs
D. PPOs - Correct Answer - C. POSs
Which of the following is a type of nerve that conducts impulses from
the brain and spinal cord to skeletal muscles for movement?
A. Sympathetic
B. Autonomic
C. Somatic
D. Incorporeal - Correct Answer - C. Somatic
According to the following hierarchy table, if a patient's documentation
states an AMI and unstable angina, which HCC(s) will be used in the
CMS calculation?
pg. 1
,A. HCC 86
B. HCC 87
C. HCC 88
D. HCC 87, HCC 88 - Correct Answer - A. HCC 86
Which of the following payment methodologies use risk-adjusting
mechanisms?
A. Health Insurance Marketplace
B. HHS-HCC
C. RBRVS
D. Both A and B - Correct Answer - B. HHS-HCC
________ is similar to the HCC models used for Medicare, but places a
greater emphasis on less common, but costly chronic conditions that are
more prevalent among disabled Medicaid beneficiaries.
A. UCSD
B. ACG
C. CDPS
D. DRG - Correct Answer - C. CDPS
Which skin diagnosis maps to a CMS-HCC?
A. Carcinoma in situ
B. Basal cell carcinoma
pg. 2
,C. Merkel cell carcinoma
D. Squamous cell carcinoma - Correct Answer - C. Merkel cell
carcinoma
_______ rating measure how well Medicare Part C and Medicare Part D
plans perform in customer service and preventive care
A. PQRS
B. STAR
C. CEHRT
D. QCDR - Correct Answer - B. STAR
What is the maximum number of stars in the MA Quality Rating
System?
A. 12
B. 5
C. 8
D. 10 - Correct Answer - B. 5
In a RADV, support for an ICD-10-CM code that was submitted was not
found; however, documentation did support a different diagnosis code
that risk-adjusted to the same HCC as the first code. What is the RADV
result for this finding?
A. Validation
B. No validation
pg. 3
, C. Fine to the MAO for poor coding
D. Fine to the physician for poor documentation - Correct Answer - A.
Validation
Which of the following was the first Medicare risk-adjustment plan?
A. Medicare Advantage
B. Medicare + Choice
C. Medicare Part C
D. Medicare Part D - Correct Answer - B. Medicare + Choice
When a record is requested from CMS for an RADV audit, a record's
suitability for RADV should include all of the following except:
A. The correct enrollee
B. A valid provider type
C. An unabridged, stand-alone medication list
D. A diagnosis that supports the HCC - Correct Answer - C. An
unabridged, stand-alone medication list
A patient is seen by their family practitioner for confusion, depression,
and behavioral changes. Upon examination, the patient cannot remember
recent events. The provider diagnoses the patient with early onset
Alzheimer's Disease with dementia What ICD-10-CM coding is
reported?
pg. 4
TEST BANK| AAPC CERTIFIED RISK ADJUSTMENT
CODER (CRC) CERTIFICATION EXAM REVIEW WITH
300 REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS/ GRADED A+ (MOST RECENT!!)
_______ are a type of episodic care payment plan used by Medicare to
pay for treatments and services provided to beneficiaries who have been
admitted into an acute care hospital.
A. APCs
B. DRGs
C. POSs
D. PPOs - Correct Answer - C. POSs
Which of the following is a type of nerve that conducts impulses from
the brain and spinal cord to skeletal muscles for movement?
A. Sympathetic
B. Autonomic
C. Somatic
D. Incorporeal - Correct Answer - C. Somatic
According to the following hierarchy table, if a patient's documentation
states an AMI and unstable angina, which HCC(s) will be used in the
CMS calculation?
pg. 1
,A. HCC 86
B. HCC 87
C. HCC 88
D. HCC 87, HCC 88 - Correct Answer - A. HCC 86
Which of the following payment methodologies use risk-adjusting
mechanisms?
A. Health Insurance Marketplace
B. HHS-HCC
C. RBRVS
D. Both A and B - Correct Answer - B. HHS-HCC
________ is similar to the HCC models used for Medicare, but places a
greater emphasis on less common, but costly chronic conditions that are
more prevalent among disabled Medicaid beneficiaries.
A. UCSD
B. ACG
C. CDPS
D. DRG - Correct Answer - C. CDPS
Which skin diagnosis maps to a CMS-HCC?
A. Carcinoma in situ
B. Basal cell carcinoma
pg. 2
,C. Merkel cell carcinoma
D. Squamous cell carcinoma - Correct Answer - C. Merkel cell
carcinoma
_______ rating measure how well Medicare Part C and Medicare Part D
plans perform in customer service and preventive care
A. PQRS
B. STAR
C. CEHRT
D. QCDR - Correct Answer - B. STAR
What is the maximum number of stars in the MA Quality Rating
System?
A. 12
B. 5
C. 8
D. 10 - Correct Answer - B. 5
In a RADV, support for an ICD-10-CM code that was submitted was not
found; however, documentation did support a different diagnosis code
that risk-adjusted to the same HCC as the first code. What is the RADV
result for this finding?
A. Validation
B. No validation
pg. 3
, C. Fine to the MAO for poor coding
D. Fine to the physician for poor documentation - Correct Answer - A.
Validation
Which of the following was the first Medicare risk-adjustment plan?
A. Medicare Advantage
B. Medicare + Choice
C. Medicare Part C
D. Medicare Part D - Correct Answer - B. Medicare + Choice
When a record is requested from CMS for an RADV audit, a record's
suitability for RADV should include all of the following except:
A. The correct enrollee
B. A valid provider type
C. An unabridged, stand-alone medication list
D. A diagnosis that supports the HCC - Correct Answer - C. An
unabridged, stand-alone medication list
A patient is seen by their family practitioner for confusion, depression,
and behavioral changes. Upon examination, the patient cannot remember
recent events. The provider diagnoses the patient with early onset
Alzheimer's Disease with dementia What ICD-10-CM coding is
reported?
pg. 4
