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A patient is admitted to the hospital for repair of an open fracture, type 1, of the head of the left femur. The patient has been previously diagnosed with symptomatic HIV. What ICD-10-CM code(s) is/are reported for the admission? S72.052B, B20 A 22-year-old female is admitted to ICU for acu...

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...

which medicare part is reimbursed based on the risk adjustment models part c who typically employs risk adjustment coders health plans is a health plan required to follow the minimum necessary rule yes, health plans are covered entities and are therefore required to follow the minim...

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 dev...

Interactions What are extra RA values or factors added when a patient has more than one major significant dx identified in model ? Quality, Promoting Interoperability, Improvement Activity, Cost MIPS Collection Types Categories When are Star Ratings publicly published? October of ea...

Risk Adjustment (a prospective payment system) The process of increasing or reducing payments to health plans to reflect higher or lower than expected spending. Risk adjusting is designed to compensate health plans that enroll an older and sicker population as a way to discourage plans from selecti...

2022 CRC Exam complete solutions

What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services? a. OIG Compliance Plan Guidance b. OIG Security Summary c. OIG Work Plan d. OIG Investigation Plan C. OIG Work Plan Rationale: Twice a year, the OIG rel...

What is an ERGOS assessment The ERGOS® assessment is a post- employment pre-placement physical work capacity evaluation. The assessment provides an excellent The obligation for rehabilitation counselors to teach advocacy skills to their clients stems from the belief that: a. clients have...

Health record (Medical Record) Written or graphic information documenting the facts and events during the rendering of patient care. SOAP notes Office visit notes organized into four sections: Subjective, Objective, Assessment, Plan EMR An electronic file wherein patients health inf...

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 I and II The definition of a best medical record for a RADV audit is: A. Documentation validates the CMS requested HCCs,...

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CRC Coding 2023

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...