Exam A Flashcards
What medication is prescribed to cancer patients to eradicate the cancer or for prophylactics?
Tamoxifen and Anna Stroz all
The best definition of a medical record for a RADV audit is: 
Documentation validates, the CMS requested HCC’s, contains all the necessary documentation elements, and has an additional HCC not requested by CMS. The guidelines state that the best medical record contains documentation that support the HCC, and all elements of proper documentation are followed, for example, signed by provider. Proper documentation is the first aspect that must be reviewed to determine the medical record could be considered a best medical record, the proper documentation is determined the additional HCC, which can decrease the amount owed to see a mess with the note makes the best medical record
Which of the following are reported by provider for beneficiaries in a Medicare advantage plan?
Providers must report all diagnoses that affect the patients evaluation care and treatment, including nature of the presenting problem. All chronic conditions such as atrial fibrillation, congestive heart failure, chronic kidney disease, rheumatoid arthritis, diabetes with manifestations, chronic obstructive, pulmonary disease, all active cancer, history on a relevant or past conditions, Z codes factors, and influence health status codes, and or E codes, external causes of injury and poisoning, and certain other consequences of external causes Conditions that have resolved should not be coded HCC scores on individual members, determined CMS reimbursement to the plan while not all codes will affect risk scores for risk adjustment. Diagnosis and demographic information should be captured at each face-to-face encounter to obtain health face measure of that members future medical needs. 
What records would be a good source for a retrospective chart audit? 
Cardiologist records. Not DME documentation not dietitian, notes, and not RN notes.
Retrospective audit should include the following attributes:
Provider, signatures, supporting documentation of the patient’s diagnosis and a date of service
Which type of audit evaluate appropriate risk scores of patients?
RADV and AVA risk adjustment date of validation and independent validation, audit or audits used in risk adjustment models to verify submitted diagnoses of patients
What information is required when submitting documentation to support a diagnosis for a RADVIVA? 
A single date of service for outpatient records, and the full inpatient set for hospital records when submitting documentation for a Red Eva, the submission should be a single date of service for the physician and other outpatient records and the full hospital record from admission to discharge for inpatient records, supporting a diagnosis
What is true regarding the CODE assignment for requirement for chronic kidney disease requiring dialysis? 
The patient should be diagnosed with CKD and is on chronic dialysis Dakota. Simon is supported by the inclusion terms under in 18.6 which state chronic kidney disease rec, chronic, requiring chronic dialysis assign Code 18.6. 
Joey is prescribed oxycodone for a back injury by his orthopedic surgeon two years ago. The surgeon documents that he would like to try another medication to dull the pain. Joey attempts to change to the newer medication but there’s breakthrough pain and he goes back to the oxycodone. Would CODE from category F 11.2 be appropriate?
No, the surgeon did not document that Joey was dependent on the oxycodone if the patient is prescribed a narcotic for long-term use and the provider does not document drug dependence a sign code Z 79.891 long-term current use of opiate analgesic
Diagnosis must be made on face-to-face encounters between members and an approved provider, such as an MD, PA or MP and status conditions like a below the knee amputation must be assessed and documented in order for payment adjustments to be received. How often should a provider see and assess a patient and a calendar year to validate amputation status?
Once a year to evaluate amputation status
APEG tube is:
Percutaneous, endoscopic, gastronomy, and a G-tube and a gastronomy
A patient is here for follow up. She was seen in the ER two weeks ago where she had an MRI of the brain which showed significant cerebral arterial sclerosis. She was diagnosed with a TIA. She has been experiencing slight memory loss. Select the correct codes.
I 67.2 and Z 86.73 cerebral arterial sclerosis is the correct primary code the personal history TIA code Z 86.73 is reported as the second Code memory loss are 41.3 would not be reported as a symptom
Patient is here for a follow up after her dialysis yesterday. What is the ICD 10 CM code for presence of an AV fistula for dialysis?
Z99.2
A patient presents for routine check up of his hypertensive heart failure. He is to continue with his current medication and diet. Select the diagnosis codes.
I 11.050.9 there is a causal relationship between hypertension and heart failure report code 11.0 the heart failure is reported as a second code, because the instructional note under code 11.0, which indicates to use additional code to identify type of heart failure.
A 54-year-old man presents for his routine follow up after renal transplant two years ago. The patient has CKD stage two and reports no other complaints, assigned the correct codes:
The guidelines indicate the president of CKD after transplant a loan does not constitute a transplant complication. Also, there is an instructional note below Code in 18 in the tabular list, indicating to use additional code to report a transplant status.
A type two diabetic presents with an insulin pump malfunction. What are the correct codes:
The guidelines indicate insulin pump malfunctions are coded to T 85.6 insulin pump malfunctions can be underdose or overdose of medication with the documentation that is non-specific such as this the only known element is pump malfunction Z 79.4 for a long-term current use of insulin is not reported separately. The complication code for the insulin pump captures the long-term drug therapy. Good to know, what you mean
What is the correct ICD 10 CM code for a patient with COPD exacerbation?
J 44.1
The patient had hip replacement surgery three days ago. The provider documents the patient has had a iatrogenic zero cerebral vascular infarction due to recent hip replacement surgery during her current hospital stay. I signed the appropriate code for the cardiovascular event:
 the guideline indicates cerebral vascular infarction that occurs of a medical intervention is coded based on whether it was interoperative or post procedural this was post procedural look in the ICD 10 alphabetic index for stroke post procedure/following other surgery referring you to 97.821 the tabular list for subcategory on 97.8 indicates to use an additional code if applicable to further specify the disorder, we have not been given further information such the location of the infarction, so no other code is required
The which ICD 10 codes selection is reported for a nursing home patient with severe dementia, often caught wandering off from the floor?
The alphabetic index look for dementia/severe/with/behavioral disturbances/specified NEC for the wandering associated with dementia look for wandering/in diseases classified elsewhere referring you to Z 91.83. And FO3 point C18. 
Patient presents to the OB for routine obstructive care. The nurse takes a patient’s blood pressure and reads 140/80 the position sees the patient and documents the following assessment and plan AP: hypertension, transient, check BP at home daily and return to clinic in two days for nurse BP check I signed the correct ICD 10 CM CODE.
The guidelines indicate to assign a code from category zero 13 for transient, hypertension and pregnancy. The trimester and the weeks of gestation are not documented resulting in the use of unspecified codes. 
