2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 10, Exams of Nursing

Download 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 10 and more Exams Nursing in PDF only on Docsity! 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS Which risk adjustment model is used by Medicaid programs? A. HCC B. CDPS C. ZIPC D. MIPS - CORRECT ANSWERS B. CDPS What does CMS' Star Ratings program monitor? A. Performance of Medicare Advantage plans B. Fraud and abuse C. Adherence to state scope of practice D. Performance of Medicare providers - CORRECT ANSWERS A. Performance of Medicare Advantage plans Which statement is TRUE regarding hierarchies? A. Used exclusively by CMS for Medicare Advantage plans B. Mandated to be used for all Medicaid payment models C. Utilized by some private payers D. All of the above - CORRECT ANSWERS C. Utilized by some private payers Which code set is used for HCC coding? I. CPT II. HCPCS Level II III. ICD-10-CM 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS IV. ICD-10-PCS A. III B. III and IV C. I and III D. I, II, III and IV - CORRECT ANSWERS A. III Data mining is performed for what purpose? A. Identify data that might be related to patient risk scores B. Look for opportunities for clinical staff incentives C. Make sure that low performing providers are penalized for poor outcomes D. To evaluate the effectiveness of compliance plans - CORRECT ANSWERS A. Identify data that might be related to patient risk scores If you were using a predictive model and the results were: • The member had a DME claim for oxygen. • The member had an Rx Claim for a bronchodilator. • The member had a medical claim which included a PFT. Which diagnosis would you predict this member has? A. Hypertension B. Emphysema C. CHF D. Diabetes - CORRECT ANSWERS B. Emphysema Predictive models are used to identify people who are at high risk of chronic illnesses having higher medical claims; what can a provider do with this information to decrease the medical costs? I. Develop disease management education programs II. Involve clinical staff to help with coordination of care 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS B. I and III C. I, II, and IV D. I, II, III and IV - CORRECT ANSWERS C. I, II, and IV What is an effective way to review documentation deficiencies with a provider? A. Have the provider read the coding guidelines prior to your training session B. Supply the provider examples of his/her documentation and suggested improvements C. Try to catch the provider between patients so the schedule is not interrupted D. Start with a summary of your credentials to gain the respect of the provider - CORRECT ANSWERS B. Supply the provider examples of his/her documentation and suggested improvements You are reviewing provider documentation for risk adjusted diagnoses so you can provide feedback to the provider. You are looking to validate diabetic neuropathy using the provider's progress note from an office visit earlier in the year. The provider documented "1. DM 2. Neuropathy - controlled, continue current meds" in the body of the progress note. You should inform the provider which of the following? A. The diagnostic statement supports the coding of a type 1 diabetic manifestation B. Diabetes and neuropathy are assumed linked unless the provider states they are not related C. The provider must indicate the site of the neuropathy for proper coding D. The provider must indicate the type of diabetes in order for a code to be selected - CORRECT ANSWERS B. Diabetes and neuropathy are assumed linked unless the provider states they are not related S: Here to follow up on her atrial fibrillation. No new problems. Feeling well. Medications are reviewed and consistent with the medications that she was discharged home. O: BP: 110/64. Pulse is regular at 72. Neck is supple. Chest is clear. Cardiac normal sinus rhythm. A: Chronic atrial fibrillation, currently stable. 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS P: 1. Prothrombin time. 2. Follow up with myself in 1 month, sooner as needed if has any other problems in the meantime. Will also check a creatinine and potassium today as well. Electronically Signed: M, Jones, M.D. Based on the review of the medical record, what discrepancy would a coder identify? A. The list of medications was not documented which would affect coding B. The provider did not document the chief complaint C. The provider did not properly sign the documentation D. There are no discrepancies with this documentation - CORRECT ANSWERS A. The list of medications was not documented which would affect coding ANESTHESIA: General. PREOPERATIVE DIAGNOSIS: Diabetic ulcer right upper thigh with exposed fat layer. POSTOPERATIVE DIAGNOSIS: Diabetic ulcer right upper thigh with exposed fat layer. PROCEDURE: Debridement of ulcer, right upper thigh. INDICATIONS: This 76-year- old female has developed an ulcer on the upper right thigh. She is here for debridement. The patient has a current history of type 2 diabetes and hypertension. DESCRIPTION OF PROCEDURE: Under general laryngeal mask anesthesia, the patient was placed in left lateral decubitus position and the right lateral thigh and hip was appropriately prepped and draped. Sharp Mayo scissor dissection was used to debride skin, subcutaneous tissue and excise the edges of the wound down to the tensor fascia. Some undermining with fat necrosis was also debrided. It was covered with gauze and a dressing. She tolerated the procedure well. What diagnosis coding should be reported? - CORRECT ANSWERS E11.622, L97.112, I10 A 66-year-old male patient with AIDS presents with new onset of shortness of breath. Tests confirm the patient has pneumocystis carinii pneumonia. What diagnosis coding should be reported? A. B59 B. B59, B20, R06.02 C. B20, B59 D. B20 - CORRECT ANSWERS C. B20, B59 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS What is the correct ICD-10-CM code for an uncertain gastrointestinal stromal tumor? A. C49.4 B. C26.9 C. D48.19 D. D37.8 - CORRECT ANSWERS C. D48.19 Which of the following is NOT true? A. Conditions listed on the problem list for a diabetic patient are coded as complications of the diabetes. B. If documentation does not state the type of diabetes but indicates the patient uses insulin report Type 2 diabetes code (E11.-). C. Documentation that indicates a cause-and-effect relationship includes "due to," "caused by," "with" and "secondary to." D. A causal relationship is assumed between diabetes and a complication when the term "with" links the two together in the Alphabetic Index. - CORRECT ANSWERS A. Conditions listed on the problem list for a diabetic patient are coded as complications of the diabetes. Which provider is NOT an approved provider for diagnosis code capture under the HCC model? A. LCSW B. CRNA C. Podiatrist D. Registered nurse - CORRECT ANSWERS D. Registered nurse Which element would NOT be taken into consideration for predictive modeling in risk adjustment? 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS The patient had hip replacement surgery three days ago. The provider documents the patient has had an "iatrogenic cerebrovascular infarction due to recent hip replacement surgery during her current hospital stay." What is the appropriate ICD-10-CM code for the cardiovascular event? A. I63.50 B. G45.9 C. I97.821 D. I63.9 - CORRECT ANSWERS C. I97.821 What is the correct ICD-10-CM code for a patient with COPD exacerbation? A. J44.1 B. J44.9 C. J45.909 D. J44.0 - CORRECT ANSWERS A. J44.1 A Type 2 diabetic presents with an insulin pump malfunction. What are the correct codes? A. T85.694A, E11.9 B. T85.694A, E11.620 C. T82.598A, E11.9 D. T82.598A, E11.620 - CORRECT ANSWERS A. T85.694A, E11.9 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. What diagnosis coding should be reported? A. N18.2, Z94.0 B. T86.10, Z94.0 C. T86.10 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS D. Z94.0, N18.2 - CORRECT ANSWERS A. N18.2, Z94.0 A patient presents for a routine checkup for his hypertensive heart failure. He is to continue with his current medication and diet. What diagnosis coding should be reported? A. I50.40, I10 B. I11.0, I50.9 C. I50.9, I10 D. I50.9 - CORRECT ANSWERS B. I11.0, I50.9 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 ANSWERS D. Z99.2 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. What diagnosis coding should be reported? A. I67.2, Z86.73 B. G45.9 C. Z86.73, R41.3 D. G45.9, I67.2, R41.3 - CORRECT ANSWERS A. I67.2, Z86.73 Which of the following is a PEG Tube categorized as? 2024 AAPC CRC PRACTICE EXAM 1 QUESTIONS AND ANSWERS NEWEST UPDATE 2024/2025 ALL ANSWERS 100% CORRECT VERIFIED BEST GRADED TO SCORE A+ FOR PASS I. Percutaneous Endoscopic Gastrostomy II. G tube III. Gastrostomy IV. Colostomy A. I B. I and III C. I, II, and III D. IV - CORRECT ANSWERS C. I, II, and III 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 ANSWERS B. Once a year 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 ANSWERS D. No, the surgeon did not document that Joey was dependent on the Oxycodone