CRC Exam Questions with Verified
Solutions
prophylaxis - ANSWER-prevention of disease
Tamoxifen - ANSWER-anti breast cancer
Anastrozole - ANSWER-anti breast cancer
The definition of a best medical record for a RADV audit is - ANSWER-Documentation
that validates all the requested HCCs and is signed by the provider
What is not reported by a provider for beneficiaries in a Medicare Advantage Plan? -
ANSWER-family history of disease, resolved conditions treated in past
What records would not be a good source for a retrospective chart audit? - ANSWER-
DME documentation, Dietician notes
RN notes
Which type of audit evaluates appropriate risk scores of patients - ANSWER-RADV and
IVA
What information is required when submitting documentation to support a diagnosis for
a RADV/IVA? - ANSWER-A single DOS for outpatient records and the full inpatient set
for hospital record
What is TRUE regarding the code assignment requirement for Chronic Kidney Disease
requiring dialysis (N18.6?) - ANSWER-The patient should be diagnosed with CKD and
is on chronic dialysis or receiving kidney transplants
Marsha has been prescribed Oxycodone for a back injury by his orthopedic surgeon two
years ago. The surgeon documents she would like to try another medication to dull the
pain. Marsha attempts to change to the newer medication but there is breakthrough
pain and she goes back to the oxycodone. Would code from F11.2 (dependence) be
appropriate? - ANSWER-No, the surgeon did not document that Marsha was dependent
on the oxycodone.
Diagnoses must be based on face-to face encounters between members and 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? -
ANSWER-Once a year
A PEG Tube is - ANSWER-Percutaneous Endoscopic Gastrostomy, Gastronomy,
Colostomy
Coders review medical records in their entirety to capture the current diagnosis codes.
In which of the following components of the record should the coder NOT capture
diagnosis codes? (one answer)
I.Exam
II.History
III.Nurse notes
IV.Consultation - ANSWER-III
The patient is seen by her primary care provider. The provider documents the patient
has diabetes, CKD stage II and CKD stage III. What should the coder do?
I.Report E11.22, N18.2, N18.30
II.Report E11.22, N18.30
III.Query the provider to determine if the diabetes in out of control
IV.Query the provider to determine the appropriate stage of CKD - ANSWER-IV
What can result from the improper use of cut and paste functions in an EHR to pull in
elements of a previous encounter? (one answer)
I.The patient could end up with duplicate claims for the same date of service
II.The provider may include diagnoses that are not relevant for the date of service
III.The nurse might provide medical care to the wrong patient
IV. The coder might overlook chronic illnesses that are currently being treated -
ANSWER-II
Which of the following is TRUE regarding the past, family, and social histories?
I.PFSH contains information regarding a patient's chronic conditions
II.PFSH includes information regarding the patient's history that may put him/her at risk
for certain conditions
III.PFSH should not be used for supporting documentation for diagnosis codes -
ANSWER-I and II
When providing physician education for documentation, the coder should (one answer):
I.Focus only on the conditions that have a risk adjustment score
II.Instruct the provider to document all diagnoses managed, treated, and monitored
III.Instruct the provider to always code using the diabetic manifestation codes
IV.Focus on the conditions that have been on the list for audit targets - ANSWER-II
What does the abbreviation MI stand for? - ANSWER-Myocardial Infarction
What is the function of the spinal cavity? (one answer)
Solutions
prophylaxis - ANSWER-prevention of disease
Tamoxifen - ANSWER-anti breast cancer
Anastrozole - ANSWER-anti breast cancer
The definition of a best medical record for a RADV audit is - ANSWER-Documentation
that validates all the requested HCCs and is signed by the provider
What is not reported by a provider for beneficiaries in a Medicare Advantage Plan? -
ANSWER-family history of disease, resolved conditions treated in past
What records would not be a good source for a retrospective chart audit? - ANSWER-
DME documentation, Dietician notes
RN notes
Which type of audit evaluates appropriate risk scores of patients - ANSWER-RADV and
IVA
What information is required when submitting documentation to support a diagnosis for
a RADV/IVA? - ANSWER-A single DOS for outpatient records and the full inpatient set
for hospital record
What is TRUE regarding the code assignment requirement for Chronic Kidney Disease
requiring dialysis (N18.6?) - ANSWER-The patient should be diagnosed with CKD and
is on chronic dialysis or receiving kidney transplants
Marsha has been prescribed Oxycodone for a back injury by his orthopedic surgeon two
years ago. The surgeon documents she would like to try another medication to dull the
pain. Marsha attempts to change to the newer medication but there is breakthrough
pain and she goes back to the oxycodone. Would code from F11.2 (dependence) be
appropriate? - ANSWER-No, the surgeon did not document that Marsha was dependent
on the oxycodone.
Diagnoses must be based on face-to face encounters between members and 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? -
ANSWER-Once a year
A PEG Tube is - ANSWER-Percutaneous Endoscopic Gastrostomy, Gastronomy,
Colostomy
Coders review medical records in their entirety to capture the current diagnosis codes.
In which of the following components of the record should the coder NOT capture
diagnosis codes? (one answer)
I.Exam
II.History
III.Nurse notes
IV.Consultation - ANSWER-III
The patient is seen by her primary care provider. The provider documents the patient
has diabetes, CKD stage II and CKD stage III. What should the coder do?
I.Report E11.22, N18.2, N18.30
II.Report E11.22, N18.30
III.Query the provider to determine if the diabetes in out of control
IV.Query the provider to determine the appropriate stage of CKD - ANSWER-IV
What can result from the improper use of cut and paste functions in an EHR to pull in
elements of a previous encounter? (one answer)
I.The patient could end up with duplicate claims for the same date of service
II.The provider may include diagnoses that are not relevant for the date of service
III.The nurse might provide medical care to the wrong patient
IV. The coder might overlook chronic illnesses that are currently being treated -
ANSWER-II
Which of the following is TRUE regarding the past, family, and social histories?
I.PFSH contains information regarding a patient's chronic conditions
II.PFSH includes information regarding the patient's history that may put him/her at risk
for certain conditions
III.PFSH should not be used for supporting documentation for diagnosis codes -
ANSWER-I and II
When providing physician education for documentation, the coder should (one answer):
I.Focus only on the conditions that have a risk adjustment score
II.Instruct the provider to document all diagnoses managed, treated, and monitored
III.Instruct the provider to always code using the diabetic manifestation codes
IV.Focus on the conditions that have been on the list for audit targets - ANSWER-II
What does the abbreviation MI stand for? - ANSWER-Myocardial Infarction
What is the function of the spinal cavity? (one answer)
