Certified Risk Adjustment Coder Practice Test Video Answers

1. B
Risk adjustment ensures provider payments are adjusted based on patient health risk factors.

2. B
Chronic conditions captured via HCC coding drive the RAF score significantly.

3. C
Only face-to-face encounter documentation is acceptable, not problem lists or labs alone.

4. B
MEAT documentation is required to validate a diagnosis for HCC reporting.

5. C
MEAT = Monitor, Evaluate/Assess, Address, Treat.

6. C
Standalone pathology reports without provider interpretation are not acceptable.

7. B
CMS maintains the HCC risk adjustment model.

8. B
ICD-10-CM diagnosis codes are used for HCC classification.

9. A
Higher severity codes override lower severity codes in the same hierarchy group.

10. B
Diabetes complications must be specified to impact RAF scores.

11. B
In outpatient settings, only confirmed conditions or symptoms are coded.

12. A
Chronic conditions must be reported annually with MEAT support.

13. B
RAF scores adjust Medicare Advantage plan payments.

14. B
Without MEAT support, the diagnosis cannot be used for risk adjustment.

15. B
Diabetes with complications maps to HCC, unlike acute minor conditions.

16. C
Medical assistants’ notes alone are not valid sources for HCC coding.

17. A
Unspecified codes often fail to map to HCCs, reducing RAF accuracy.

18. A
Suspecting identifies potential diagnoses for provider validation, not auto-coding.

19. B
Mapping refers to linking ICD-10-CM codes to HCCs.

20. C
Minor acute conditions like colds do not risk adjust.

21. B
Annual wellness visits validate chronic diagnoses yearly.

22. A
CKD stage 4 should be coded with N18.4 to capture severity.

23. C
Ordering labs demonstrates monitoring a condition.

24. B
Chronic conditions must be reported every calendar year.

25. A
Physicians, NPs, and PAs can document diagnoses; coders cannot.

26. A
Prospective reviews occur before claim submission, retrospective after.

27. B
Problem list diagnoses without MEAT support are often flagged in audits.

28. A
ICD-10-CM updates annually on October 1.

Medical coders specializing in cardiology often also prepare with our Certified Ambulatory Surgery Center Coder practice test, as both credentials require precise procedural coding knowledge in specialty clinical settings.