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CRC Exam With Latest Updated Questions And Answers 2024
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CRC Exam With Latest Updated Questions And Answers 2024
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CRC Exam With Latest Updated QuestionsAnd Answers 2024
Risk .Adjustment .(a .prospective .payment .system) .- .correct .answer.The .process .of
.increasing .or .reducing .payments .to .health .plans .to .reflect .higher .or .lower .than .expected
.spending. .Risk .adjusting .is .designed .to .compensate .health .plans .that .enroll .an .older .and
.sicker .population .as .a .way .to .discourage .plans .from .selecting .only .healthier .enrollees.
What .is .the .goal .when .coding .for .risk .adjustment? .- .correct .answer.code .ALL .current .dx
What .is .the .purpose .of .collecting .dx .in .risk .adjustment .coding? .- .correct .answer.Adjust
.potential .risk .
measure .& .eval .all .Pts .on .an .equal .scale .levels .the .playing .field .of .age, .race, .gender, .&
.socioeconomics
What .is .the .acronym .for .risk .adjustment .coding? .- .correct .answer.HCC .(Hierarchical
.Condition .Category)
What .elements .would .NOT .be .taken .in .to .consideration .for .risk .adjustment? .- .correct
.answer.number .of .years .Pt. .has .been .covered .under .medicare .advantage
Which .medical .records .can .be .submitted .for .HCC .validation? .- .correct .answer.+MD .office
.progress .note
+Outpatient .hospital
+Critical .access .hospital
What .is .the .purpose .of .risk .adjustment .values? .- .correct .answer.to .budget .care .of .a
.patient .for .the .following .year
What .are .risk .adjustment .models .used .for? .- .correct .answer.To .determine .projected
.costs .of .healthcare .based .on .the .conditions .of .patients
Which .is .NOT .to .be .taken .into .consideration .for .risk .adjustment? .- .correct
.answer.Frequency .of .office .visits
How .is .predictive .modeling .used .in .risk .adjustment? .- .correct .answer.determine
.suspected .dx .based .on .data .elements
,What .is .the .reporting .period .for .risk .adjustment .coding? .- .correct .answer.Jan .> .Dec
What .risk .adjustment .model .is .used .by .Medicaid? .- .correct .answer.CDPS .(Chronic
.Illness .& .Disability .Payment .System)
What .is .CDPS? .- .correct .answer.Chronic .Illness .& .Disability .Payment .System
What .risk .adjustment .model .incorporates .High, .Medium, .& .Low .risk .in .the .numeric .value .-
.correct .answer.CDPS
what .is .the .default .if .type .of .DM .is .not .specified? .- .correct .answer.DM2
How .to .code .when .a .Pt. .is .seen .for .management .of .anemia .d/t .malignancy? .- .correct
.answer.1st .code .- .malignancy
2nd .code .- .anemia
How .to .code .tobacco .use .AND .dependence .on .tobacco .- .correct .answer.only .code
.dependence .on .tobacco .(F17.2-)
What .is .the .length .of .time .for .a .MI .to .be .considered ."acute"? .- .correct .answer.4 .weeks/28
.days
How .is .glaucoma .reported? .- .correct .answer.only .code .stage .of .glaucoma
What .is .the .sequencing .order .when .coding .a .sequela .(late .effect)? .- .correct .answer.1st-
.residual .condition
2nd- .cause .of .the .late .effect
What .is .reported .by .a .provider .for .beneficiaries .in .Medicare .Advantage .plans? .- .correct
.answer.presenting .problems, .&
all .chronic .conditions
How .often .should .a .provider .see .a .Pt. .to .validate .amputation .status? .- .correct
.answer.once .a .year
PEG .Tube .- .correct .answer.+percutaneous .endoscopic .gastrostomy .tube
+G-tube
+gastrostomy
All .conditions .listed .on .the .problem .list .for .DM .patients .are .coded .as .complications .of .DM:
.True .or .False? .- .correct .answer.False
What .is .true .regarding .hierarchies? .- .correct .answer.Utilized .by .some .private .payers
, Quality .Measures .like .Star .Ratings .and .HEDIS .have .NO .correlation .with .the .medical
.record .that .is .collected .to .support .risk .adjustment. .TRUE .or .FALSE? .- .correct
.answer.FALSE
Is .HEDIS .a .division .of .CMS .or .Medicaid? .- .correct .answer.NO
Who .developed .HEDIS? .- .correct .answer.NCQA .(National .Committee .for .Quality
.Assurance)
How .is .HEDIS .data .collected? .- .correct .answer.+surveys
+medical .chart .reviews
+insurance .claims
What .is .the .goal .of .HEDIS .(Health .Plan .Employer .Data .Info .Set)? .- .correct .answer.for
.consumers .to .compare .health .plans
How .often .are .HEDIS .measures .revised? .- .correct .answer.Annually
Which .payers .uses .HEDIS .measures? .- .correct .answer.a .variety
RADV .- .correct .answer.Risk .Adjustment .Data .Validation
What .is .the .purpose .of .a .RADV .audit? .- .correct .answer.Verify .accuracy .of .dx .submitted
.for .payment
When .submitting .records .for .RADV .audit, .will .additional .current .dx .that .were .not .originally
.reported .by .considered .when .documentation .is .submitted .for .the .audit? .- .correct
.answer.Yes! .additional .current .dx .not .included .on .claims .data .may .be .approved .during
.the .audit. .The .submission .of .all .dx .(w/HCCs) . are .cumulative, .so .there .may .be .a .neg. .or .a
.pos. .outcome .overall .from .a .$ .perspective
What .info .is .verified .during .RADV .audit? .- .correct .answer.All .dx .codes .are .supported .in
.the .medical .record
Which .of .the .following .criteria .would .be .components .of .an .acceptable .medical .record .in .a
.RADV? .- .correct .answer.+encounter .must .be .a .face-to-face .visit
+encounter .must .be .from .an .acceptable .provider .type
+condition(s) .must .be .documented .in .the .medical .rec.
+encounter .must .include .a .signature .or .attestation
How .many .records .are .submitted .per .Pt. .in .a .RADV .audit? .- .correct .answer.5
Definition .of .the .best .record .for .a .RADV .audit .- .correct .answer.documentation .validates
.the .CMS .requested .HCCs, .
contains .all .the .necessary .documentation .elements, .&
has .ADDITIONAL .HCCs .not .requested .by .CMS
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