Certified Risk Adjustment CRC –Practice
Exam Questions and Answers – Complete
Exam Preparation Material
Introduction:
This document contains comprehensive practice questions and
precise answers for the Risk Adjustment CRC (Certified Risk
Adjustment Coder) exam. It covers ICD-10-CM coding scenarios,
HCC and RAF concepts, RADV audits, CMS guidelines,
documentation standards, risk adjustment models, and compliance
principles. The material includes both theoretical concepts and
applied coding cases to support full exam preparation.
Exam Questions and Answers:
Patient is admitted to the hospital for treatment of a Subarachnoid
Hemorrhage. The patient has hypertension and is being evaluated
by Neurosurgery for possible surgical intervention. Assign the
correct ICD-10-CM code(s) for the admission. ---Correct precise
answer---I60.9, I10
The provider sees a patient in the Emergency room for acute flank
pain. The patient has high blood pressure after serial BPs taken.
The ultrasound shows acute pyelonephritis. The provider
,documents acute pyelonephritis and secondary hypertension.
Assign the correct ICD-10-CM codes. ---Correct precise answer---
N10, I15.8 Remember this needs the TRANSIENT HTN code.
A 77 year-old male presents for follow up with his primary care
provider. The provider documents a healed pressure ulcer of the
right heel and hypertension. The Assessment and Plan is: A/P
healed pressure ulcer of right heel, no further treatment and
hypertension. ---Correct precise answer---I10, Do not code the
healed Pressure Ulcer
What is predictive modeling? ---Correct precise answer---Analysis
of data to determine a hypothesis related to the future health care
needs of patients.
Which statement is TRUE regarding risk adjustment models? ---
Correct precise answer---Risk scores are used to adjust payments
for each beneficiary's expected expenditures
Which of the following can effect RAF score? ---Correct precise
answer---1.Reporting the manifestation of a chronic illness
2. Disease interactions.
3.Patient age
, What does the abbreviation RAPS indicate? ---Correct precise
answer---Risk Adjustment Processing System
What is a disease Hierarchy? ---Correct precise answer---
combination of multiple ICD-9-CM/ICD-10-CM diagnosis codes that
address multiple levels of severity for a disease with varying levels
of associated medical costs
Which risk adjustment model incorporates high, medium, and low
risk in the numeric value? ---Correct precise answer---CDPS
Which statement is TRUE regarding the HCC blended model? ---
Correct precise answer---Eases the transition from one year's
model to the next because of potential lost values
Which element of the documentation includes the provider's
objective findings? ---Correct precise answer---Exam
What is the purpose of collecting diagnoses in risk adjustment
coding? ---Correct precise answer---Risk adjustment factor
What does the acronym MEAT stand for? ---Correct precise answer-
--Monitor, Evaluate, Assess, Treat
Exam Questions and Answers – Complete
Exam Preparation Material
Introduction:
This document contains comprehensive practice questions and
precise answers for the Risk Adjustment CRC (Certified Risk
Adjustment Coder) exam. It covers ICD-10-CM coding scenarios,
HCC and RAF concepts, RADV audits, CMS guidelines,
documentation standards, risk adjustment models, and compliance
principles. The material includes both theoretical concepts and
applied coding cases to support full exam preparation.
Exam Questions and Answers:
Patient is admitted to the hospital for treatment of a Subarachnoid
Hemorrhage. The patient has hypertension and is being evaluated
by Neurosurgery for possible surgical intervention. Assign the
correct ICD-10-CM code(s) for the admission. ---Correct precise
answer---I60.9, I10
The provider sees a patient in the Emergency room for acute flank
pain. The patient has high blood pressure after serial BPs taken.
The ultrasound shows acute pyelonephritis. The provider
,documents acute pyelonephritis and secondary hypertension.
Assign the correct ICD-10-CM codes. ---Correct precise answer---
N10, I15.8 Remember this needs the TRANSIENT HTN code.
A 77 year-old male presents for follow up with his primary care
provider. The provider documents a healed pressure ulcer of the
right heel and hypertension. The Assessment and Plan is: A/P
healed pressure ulcer of right heel, no further treatment and
hypertension. ---Correct precise answer---I10, Do not code the
healed Pressure Ulcer
What is predictive modeling? ---Correct precise answer---Analysis
of data to determine a hypothesis related to the future health care
needs of patients.
Which statement is TRUE regarding risk adjustment models? ---
Correct precise answer---Risk scores are used to adjust payments
for each beneficiary's expected expenditures
Which of the following can effect RAF score? ---Correct precise
answer---1.Reporting the manifestation of a chronic illness
2. Disease interactions.
3.Patient age
, What does the abbreviation RAPS indicate? ---Correct precise
answer---Risk Adjustment Processing System
What is a disease Hierarchy? ---Correct precise answer---
combination of multiple ICD-9-CM/ICD-10-CM diagnosis codes that
address multiple levels of severity for a disease with varying levels
of associated medical costs
Which risk adjustment model incorporates high, medium, and low
risk in the numeric value? ---Correct precise answer---CDPS
Which statement is TRUE regarding the HCC blended model? ---
Correct precise answer---Eases the transition from one year's
model to the next because of potential lost values
Which element of the documentation includes the provider's
objective findings? ---Correct precise answer---Exam
What is the purpose of collecting diagnoses in risk adjustment
coding? ---Correct precise answer---Risk adjustment factor
What does the acronym MEAT stand for? ---Correct precise answer-
--Monitor, Evaluate, Assess, Treat
