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CRC Training
Certified Risk Adjustment Coder, a certification offered by the American Academy of Professional Coders (AAPC). This certification is designed for coders who specialize in risk adjustment coding, particularly in the context of Medicare Advantage and other risk adjustment models.
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Compliance
These questions will assess your knowledge of the process for prospective audits, for RADV audits, and for retrospective audits, and your ability to identify common coding errors identified in RADV audits
Compliance
These questions will assess your knowledge of the process for prospective audits, for RADV audits, and for retrospective audits, and your ability to identify common coding errors identified in RADV audits
Documentation improvement
These questions will assess your ability to apply Coding Clinic guidance to coding scenarios, and identify common coding errors in risk adjustment as well as the diagnosis codes that risk adjust. Additionally, you must demonstrate the ability to properly code:
- Amputations
- Artificial openings
- Atherosclerosis
- AV fistulas
- CHF
- CKD
- Complications of devices
- COPD
- CVA/Stroke
- Dementia
- Depression
- DVT
- Hypertension
- Malnutrition
- Manifestations of diseases (e.g., DM, stroke, COPD)
- Mental disorders
- Neoplasms
- Pneumonia
- Pressure ulcers
- Pulmonary embolism
- Pulmonary fibrosis
- Seizures
- Skin ulcers
Diagnosis coding
These questions will assess your ability to apply Coding Clinic guidance to coding scenarios, and identify common coding errors in risk adjustment as well as the diagnosis codes that risk adjust. Additionally, you must demonstrate the ability to properly code:
- Amputations
- Artificial openings
- Atherosclerosis
- AV fistulas
- CHF
- CKD
- Complications of devices
- COPD
- CVA/Stroke
- Dementia
- Depression
- DVT
- Hypertension
- Malnutrition
- Manifestations of diseases (e.g., DM, stroke, COPD)
- Mental disorders
- Neoplasms
- Pneumonia
- Pressure ulcers
- Pulmonary embolism
- Pulmonary fibrosis
- Seizures
- Skin ulcers
Diagnosis coding
This section will test your knowledge on communicating documentation discrepancies with providers and your ability to identify documentation discrepancies
- Pathophysiology/medical terminology/anatomy :
This section will assess your ability to identify common acronyms for industry and medical terminology, and identify anatomic structures, locations, and functions. You also will be asked to define common medical terms and explain disease processes and interactions for common chronic conditions.
- Purpose and use of risk adjustment models :
This section will ask that you explain the use of data mining and predictive modeling from data captured through risk adjustment coding. You must also demonstrate the ability to apply trumping in the risk adjustment hierarchy.
- Quality of care
This area will test your ability to explain the purpose of HEDIS and STAR ratings, as well as their alignment with risk adjustment.
- Risk adjustment models : (15 questions) This section will assess your ability to apply the ACA, CDPS, HCC, and private payer risk adjustment models. You also will be asked to list the elements needed to determine the risk adjustment score.
- Cases : Each case will test your ability to accurately code diagnoses based on medical record documentation and to report diagnoses that risk adjust.
Diagnosis coding
This section will test your knowledge on communicating documentation discrepancies with providers and your ability to identify documentation discrepancies
- Pathophysiology/medical terminology/anatomy : This section will assess your ability to identify common acronyms for industry and medical terminology, and identify anatomic structures, locations, and functions. You also will be asked to define common medical terms and explain disease processes and interactions for common chronic conditions.
- Purpose and use of risk adjustment models : This section will ask that you explain the use of data mining and predictive modeling from data captured through risk adjustment coding. You must also demonstrate the ability to apply trumping in the risk adjustment hierarchy.
- Quality of care: This area will test your ability to explain the purpose of HEDIS and STAR ratings, as well as their alignment with risk adjustment.
- Risk adjustment models : (15 questions) This section will assess your ability to apply the ACA, CDPS, HCC, and private payer risk adjustment models. You also will be asked to list the elements needed to determine the risk adjustment score.
- Cases : Each case will test your ability to accurately code diagnoses based on medical record documentation and to report diagnoses that risk adjust.
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