AAPC CRC TEST STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH VERIFIED CORRECT ANSWERS || 100% GUARANTEED PASS LATEST VERSION

AAPC CRC TEST STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH VERIFIED CORRECT ANSWERS || 100% GUARANTEED PASS LATEST VERSION 1. which medicare part is reimbursed based on the risk adjustment models - ANSWER part c 2. who typically employs risk adjustment coders - ANSWER health plans 3. is a health plan required to follow the minimum necessary rule - ANSWER yes, health plans are covered entities and are therefore required to follow the minimum necessary rule 4. what is an example of fraud - ANSWER reporting a diagnosis or co morbidity that does not exist to obtain higher reimbursement 5. which part of medicare is also called medicare advantage - ANSWER part c 6. which health insurance assistance program is sponsored by federal and state governments - ANSWER medicaid 7. what OIG document should a medicare advantage participant review for potential problem areas that will receive special scrutiny in the upcoming year - ANSWER OIG work plan 8. which code set is used by risk adjustment coders - ANSWER icd-10-cm 9. which regulation strengthens HIPAA rules by addressing privacy and security concerns associated with the electronic transmission of health information - ANSWER Health Information Technology for Economic and Clinical Health Act (HITECH) 10. what is coding - ANSWER translating a written or dictated medical record into a series of alphanumeric codes 11. which organ is in the thoracic cavity - ANSWER lungs 12. what does the term distal indicate - ANSWER farther from the point of attachment 13. what is suspect logic - ANSWER using known data elements to establish a hypothesis related to the future health of patients 14. true or false: report all documented conditions that coexist at the time of the encounter - ANSWER true 15. a patient is respirator dependent and has a tracheostomy in need of revision due to redundant scar tissue formation surrounding the site. under general anesthesia and establishing the airway to maintain ventilation, the scar tissue is resected and then repair is accomplished using a layered closure - ANSWER L90.5, z43.0, z99.11 16. while in the hospital, the patient developed an intra-muscular infection at the surgical site of a total knee replacement. the diagnosis is staphylococcus sepsis. the infectious disease provider visits the patient to discuss the diagnosis and treatment plan - ANSWER t81.42xa, t81.44xa, a41.2 17. a 71 year old presents to the outpatient clinic at the local hospital with copd, congestive heart failure, and hypertension. after a comprehensive evaluation, the physician makes adjustments to the patients hypertension medication due to the hypertension being uncontrolled. the patients other conditions were documented as stable. the patient is to follow-up in 2 weeks - ANSWER i11.0, i50.9, j44.9 18. a patient with hypertensive heart disease sees the ophthalmologist for headaches and double vision. the ophthalmologist makes a diagnosis of bilateral hypertensive retinopathy of both eyes - ANSWER h35.003, i11.9 19. Which of the following medications are prescribed to cancer patients to eradicate the cancer or for prophylaxis? I. II. III. Tamoxifen Anastrozole Januvia IV. Crestor - ANSWER I and II 20. 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 - ANSWER A. Documentation validates the CMS requested HCCs, contains all the necessary documentation elements and has an additional HCC not requested by CMS 21. Which of the following are reported by a provider for beneficiaries in a Medicare Advantage Plan? I. II. III. Nature of the presenting problem Resolved conditions that have been treated in the past 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 - ANSWER C. I and IV 22. 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 - ANSWER B. Cardiologist records 23. Retrospective audits should include the following attributes: I. Provider signatures II. Supporting documentation of the patient's diagnoses III. DOS - ANSWER D. I, II and III 24. Which type of audit evaluates appropriate risk scores of patients? A. UPIC B. RADV and IVA C. RAC D. CERT - ANSWER B. RADV and IVA 25. 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 - ANSWER C. A single DOS for outpatient records and the full inpatient set for hospital records 26. 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. - ANSWER C. The patient should be diagnosed with CKD and is on chronic dialysis.