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Extra risk adjustment values or factors added when a patient has more than one major significant diagnosis identified in the model. interactions When are retrospective reviews usually performed? After the diagnosis and risk factor has been reported to CMS. Which risk adjustment model...

Highly audited ares for risk adjustment are: Cancer, strokes, fractures, and acute MIs How many diagnosis codes can a provider submit in the outpatient space? 12 Medicare Part A helps cover: inpatient hospital care care provided in skilled nursing facilities hospice care ho...

Risk Adjustment Data Element Age, Gende, Socioeconomic status, Disability status, Insurance status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes, special patient-specific conditions hospice, ESRD RAF Risk Adjustment Factor Scores Three...

APC Ambulatory Payment Classification ARRA American Recovery and Reinvestment Act of 2009 ASC Ambulatory Surgical Center CF conversion factor CPC Certified Professional Coder GPCI Geographic Practice Cost Index HCPCS Healthcare Common Procedure Coding...

Risk Adjustment CRC exam questions and answers 2023 update

HCC Coding Risk Adjustment with complete solutions

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 A. I and II B. I and III C. II and III D. I, II, III and IV A. I and II The definition of a best medical record for a R...

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 A. I and II B. I and III C. II and III D. I, II, III and IV A. I and II The definition of a best medical record for a R...

MEAT substantiation Monitor, Evaluate, Assess/Adress, Treat MEAT (monitor) signs, symptoms, disease progression, disease regression MEAT (evaluate) test results, medication effectiveness, response to treatment MEAT (assess/address) ordering tests, discussion, review record...

Who are covered entities according to HIPAA? Health Care Providers Health Plans Health Care Clearinghouses Risk Adjustment Coders should have knowledge in? The use of medications, treatments of the patient, and diagnostic testing. What document assists provider offices with the d...

Which of the following elements would be taken into consideration for risk adjustment? 1) Gender 2) Place of service 3) Provider type 4) Socioeconomic status 5) Insurance status (Medicare, Medicaid, duel-eligible) 6) special patient specific conditions for example involvement in hospice or bei...

Extra risk adjustment values or factors added when a patient has more than one major significant diagnosis identified in the model. interactions When are retrospective reviews usually performed? After the diagnosis and risk factor has been reported to CMS. Which risk adjustment mod...

The goal for risk adjustment coders is... to code all current conditions following ICD-10-CM Guidelines. When should coexisting conditions be reported? 1 - When the condition affects the treatment of an acute condition. 2 - The condition affects the management of an exacerbated chronic condit...