AAPC - CRC TEST 1
Data mining is performed to:
A. Identify data that might be related to patient risk scores
B. Look for opportunities for clinical staff incentives
C. Make sure that low performing providers are penalized for poor outcomes
D. To evaluate the effectiveness of compliance plans
correct answer ✅A.Identify data that might be related to patient risk
scores
A Type 2 diabetic presents with an insulin pump malfunction. What are the
correct codes?
A. T85.694A, E11.9
B. T85.694A, E11.620
C. T82.598A, E11.9
D. T82.598A, E11.620 - correct answer ✅A. T85.694A, E11.9
Which of the following is FALSE regarding Atherosclerosis?
A. Can affect the coronary (heart) arteries
B. Affects the veins
,C. Is promoted by LDL (low density lipoprotein - bad cholesterol) and protected
by HDL (high density lipoprotein - good cholesterol)
D. Is a chronic disease that can remain asymptomatic for decades - correct
answer ✅B. Affects the veins
,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 - correct answer ✅A. 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 - correct answer ✅A. 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 - correct answer ✅C. 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 - correct answer ✅B. Cardiologist records
Data mining is performed to:
A. Identify data that might be related to patient risk scores
B. Look for opportunities for clinical staff incentives
C. Make sure that low performing providers are penalized for poor outcomes
D. To evaluate the effectiveness of compliance plans
correct answer ✅A.Identify data that might be related to patient risk
scores
A Type 2 diabetic presents with an insulin pump malfunction. What are the
correct codes?
A. T85.694A, E11.9
B. T85.694A, E11.620
C. T82.598A, E11.9
D. T82.598A, E11.620 - correct answer ✅A. T85.694A, E11.9
Which of the following is FALSE regarding Atherosclerosis?
A. Can affect the coronary (heart) arteries
B. Affects the veins
,C. Is promoted by LDL (low density lipoprotein - bad cholesterol) and protected
by HDL (high density lipoprotein - good cholesterol)
D. Is a chronic disease that can remain asymptomatic for decades - correct
answer ✅B. Affects the veins
,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 - correct answer ✅A. 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 - correct answer ✅A. 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 - correct answer ✅C. 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 - correct answer ✅B. Cardiologist records
