Question 1

Documentation from which of the following facility settings contributes to the CMS-HCC risk score?

Options :

A : Freestanding ambulatory surgical center

B : Hospital ambulatory clinic

C : Hospice care

D : Renal dialysis center

Answer: B

Question 2

If a patient is being seen for follow-up and the documentation indicates that the patient wasadmitted to the hospital 28 days ago with an acute cerebral infarction with remaining right-sidedweakness, which of the following diagnoses would be MOST appropriate?

Options :

A : Cerebral infarction, unspecified, hemiparesis affecting right dominant side

B : Hemiparesis following cerebral infarction affecting unspecified side

C : Hemiparesis following cerebral infarction affecting right dominant side

D : Other sequelae of cerebral infarction

Answer: C

Question 3

A female patient presents for her yearly wellness check-up. Her vital signs are within normal limitswith the exception of dyspnea. Her weight is 165 lbs, up 10 lbs from her previous clinic visit 2 weeksprior. Problem list includes diagnoses of obesity, COPD, heart failure, and diabetes withoutcomplications. The patients A1c noted 9.2 up from 7.2 from previous year wellness exam. Based onthe clinical indicators, which of the following medications should be evaluated and addressed duringthis clinic visit?

Options :

A : Megace and ferrous sulfate

B : Metformin and methotrexate

C : NovoLog and Lasix

D : Wellbutrin and Allegra

Answer: C

Question 4

A provider has been determined to be a high-cost provider after a total claims cost analysis. Theproviders patient panel has an overall low HCC average score. Which of the following is the MOSTlikely explanation regarding the low HCC average score?

Options :

A : The provider cares for patients of a higher acuity

B : The provider is failing to capture all relevant diagnoses

C : The provider has a less complex patient population

D : The provider is not reporting unspecified diagnoses

Answer: B

Question 5

Which of the following physician performance metrics BEST illustrates provider engagement withoutpatient CDI specialist?

Options :

A : Query response rates and problem list updates

B : Problem list updates and RAF capture rates

C : Physician MIPS scores and query response rates

D : Physician RAF scores and RAF capture rates

Answer: A