AAPC - CRC TEST 1 QUESTIONS &
ANSWERS|| 2025 LATEST UPDATE!!!
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 - ANSWERA. 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 - ANSWERA. 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 - ANSWERC. 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 - ANSWERB. Cardiologist records
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS - ANSWERD. I, II and III
, Which type of audit evaluates appropriate risk scores of patients?
A. ZPIC
B. RADV
C. RAC
D. CERT - ANSWERB. 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 - ANSWERC. 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. - ANSWERC. 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 -
ANSWERD. 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
ANSWERS|| 2025 LATEST UPDATE!!!
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 - ANSWERA. 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 - ANSWERA. 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 - ANSWERC. 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 - ANSWERB. Cardiologist records
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS - ANSWERD. I, II and III
, Which type of audit evaluates appropriate risk scores of patients?
A. ZPIC
B. RADV
C. RAC
D. CERT - ANSWERB. 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 - ANSWERC. 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. - ANSWERC. 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 -
ANSWERD. 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
