AAPC CRC Practice Exam 1 UPDATED
QUESTIONS AND CORRECT ANSWERS
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 - CORRECT ANSWER 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
A. I
B. II and III
C. I and IV
,D. I, II, III and IV - 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
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS - CORRECT ANSWER D. I, II and III
Which type of audit evaluates appropriate risk scores of patients?
A. UPIC
B. RADV and IVA
C. RAC
D. CERT - CORRECT ANSWER B. RADV and IVA
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 - CORRECT
ANSWER C. 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.
D. The diagnosis should only be reported when the patient is diagnosed with chronic renal
insufficiency. - CORRECT ANSWER C. The patient should be diagnosed with CKD
and is on chronic dialysis.
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 -
CORRECT ANSWER D. 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 approved
provider such as 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
D. Every two years - CORRECT ANSWER B. Once a year
A PEG Tube is:
I. Percutaneous Endoscopic Gastrostomy
, II. G tube
III. Gastrostomy
IV. Colostomy - CORRECT ANSWER C. I, II, and III
Patient is here for follow up. She was seen in the ER two weeks ago where she had an MRI
of the brain which showed significant cerebral arteriosclerosis. She was diagnosed with a
TIA. She has been experiencing slight memory loss. Select the correct code(s).
A. I67.2, Z86.73
B. G45.9
C. Z86.73, R41.3
D. G45.9, I67.2, R41.3 - CORRECT ANSWER A. I67.2, Z86.73
Patient is here for follow up after her dialysis yesterday. What is the ICD-10-CM code for
presence of an AV fistula for dialysis?
A. T82.818D
B. I77.0
C. Z49.31
D. Z99.2 - CORRECT ANSWER D. Z99.2
A patient presents for a routine checkup for his hypertensive heart failure. He is to continue
with his current medication and diet. Select the diagnosis code(s).
A. I50.40, I10
B. I11.0, I50.9
C. I50.9, I10
D. I50.9 - CORRECT ANSWER B. I11.0, I50.9
Today a 54-year-old man presents for his routine follow up after renal transplant two years
ago. The patient has CKD stage 2 and reports no other complaints. Assign the correct ICD-
10-CM code(s).
A. N18.2, Z94.0
B. T86.10, Z94.0
QUESTIONS AND CORRECT ANSWERS
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 - CORRECT ANSWER 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
A. I
B. II and III
C. I and IV
,D. I, II, III and IV - 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
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS - CORRECT ANSWER D. I, II and III
Which type of audit evaluates appropriate risk scores of patients?
A. UPIC
B. RADV and IVA
C. RAC
D. CERT - CORRECT ANSWER B. RADV and IVA
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 - CORRECT
ANSWER C. 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.
D. The diagnosis should only be reported when the patient is diagnosed with chronic renal
insufficiency. - CORRECT ANSWER C. The patient should be diagnosed with CKD
and is on chronic dialysis.
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 -
CORRECT ANSWER D. 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 approved
provider such as 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
D. Every two years - CORRECT ANSWER B. Once a year
A PEG Tube is:
I. Percutaneous Endoscopic Gastrostomy
, II. G tube
III. Gastrostomy
IV. Colostomy - CORRECT ANSWER C. I, II, and III
Patient is here for follow up. She was seen in the ER two weeks ago where she had an MRI
of the brain which showed significant cerebral arteriosclerosis. She was diagnosed with a
TIA. She has been experiencing slight memory loss. Select the correct code(s).
A. I67.2, Z86.73
B. G45.9
C. Z86.73, R41.3
D. G45.9, I67.2, R41.3 - CORRECT ANSWER A. I67.2, Z86.73
Patient is here for follow up after her dialysis yesterday. What is the ICD-10-CM code for
presence of an AV fistula for dialysis?
A. T82.818D
B. I77.0
C. Z49.31
D. Z99.2 - CORRECT ANSWER D. Z99.2
A patient presents for a routine checkup for his hypertensive heart failure. He is to continue
with his current medication and diet. Select the diagnosis code(s).
A. I50.40, I10
B. I11.0, I50.9
C. I50.9, I10
D. I50.9 - CORRECT ANSWER B. I11.0, I50.9
Today a 54-year-old man presents for his routine follow up after renal transplant two years
ago. The patient has CKD stage 2 and reports no other complaints. Assign the correct ICD-
10-CM code(s).
A. N18.2, Z94.0
B. T86.10, Z94.0
