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CRC EXAM QUESTIONS WITH ACCURATE ANSWERS.
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CRC EXAM QUESTIONS WITH ACCURATE ANSWERS.
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CRC EXAM QUESTIONS WITHACCURATE ANSWERS.
Risk Adjustment Data Element ANS - Age, Gende, Socioeconomic status, Disability status, Insurance
status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes,
special patient-specific conditions hospice, ESRD
RAF ANS - Risk Adjustment Factor Scores
Three main types of reviews ANS - Retrospective, Concurrent and prospective
Retrospective ANS - reviews are performed after the information has been reported and in risk
adjustment these are prior years dos
Concurrent reviews ANS - performed ongoing as patients are seen prior to reporting and in risk
adjustment the current year
Prospective reviews ANS - will effect the next year and not the current year where payment is
concerned. They are used to forcast
Types of Risk Adjustment Models(HHS) ANS - HHS hEALTH AND HUMAN SERVICES hIERARCHICAL
CONDITION(Commercial, individual and small grooup
Types of Risk Adjustment Modles(CDPS) ANS - Chronic Illness and Disability payment
systems(Medicaid)
Types of Risk Adjustment Models(HCC-C) ANS - Hierarchical Condition Category, Part C
Types of Risk Adjustment model (DRG) ANS - Diagnosis Related Group (Inpatient)
, Types of Risk Adjustment model (ACG) ANS - Adjusted Clinical Groups(Outpatient)
Prescription based program risk adjustment examples:UCSD ANS - Medicaid Rx(UCSD)
Prescription based program risk adjustment examples(Dxcg) ANS - RxGroups(DxCG)
Prescription based program risk adjustment examples(HCC-D) ANS - Hierarchical Condition Category,
Part D(HCC-D
Trump List ANS - Families or hierarchies set a value base on severity of illness with more severe
diagnoses carrying the overall risk score for that family.
Stage 1 Pressure Ulcer ANS - Persistent focal erythema
stage 2 pressure ulcer ANS - Partial thickness skin loss involving epidermis, dermis, or both
Stage 3 pressure ulcer ANS - Full Thickness skin loss extending through subcutaneous tissue
Stage 4 Pressure ulcer ANS - Necrosis of soft tissue extending to muscle and bone
Unstageable Ulce ANS - is covered in eschar or slough it cannot be determine how deep
Pathologic Fractures ANS - Broken bone that occures in an area of weakened bone. The cause typically
due to another disease such as neoplasm or osteoporosis
Stress Fractures ANS - repeated force or overuse. these fractures are considered non-traumatic
malunion fracture ANS - a healed fracture in a undesirable position resulting in a deformity or crooked
limb.
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