In the edema case, before the CDI process, we watched the risk factor build for

In the edema case, before the CDI process, we watched the risk factor build for the 76-year-old female. Identify the HCCs assigned by the calculator (select all that apply): Question 1 options: HCC 23 Other Significant Endocrine and Metabolic Disorders HCC 59 Major Depressive, Bipolar, and Paranoid Disorders HCC 19 Diabetes without complication HCC 85 Congestive Heart Failure Question 2 (1 point) Saved If ICD-10-CM codes are identified in encoding software or physical coding manuals, what is the rationale for an HCC calculation software tool? Question 2 options: Assist with provider education Test effects of various diagnostic code assignments Optimize reimbursement All of the above Question 3 (1 point) Which of the following represents the risk factor for the patient in Case 1 when built using CMS v28? Question 3 options: This patient is relatively healthy with a score under 1.00 This patient does not risk adjust and has no HCC This patient has a slight risk adjustment of 1.023 This patient is very healthy as the HCC score is above 1.00 Question 4 (1 point) If the coder added other diabetes-related diagnoses to this encounter such as E13.22, I13.0, N18.31 and E11.40, they would receive which of the following factors in the HCC calculation results? Question 4 options: Dual benefit patient case Unable to risk adjust Addition of HCC 125 Condition interaction Question 5 (1 point) What is the calculated risk adjustment for the diabetes diagnosis in this case using CMS v28? Question 5 options: 0.323 0.309 0.166 0.331 Question 6 (1 point) Saved Which of the following ICD-10-CM codes risk adjusts for hemiplegia and hemiparesis? Question 6 options: G81 hemiplegia and hemiparesis G81.9 hemiplegia, unspecified G81.94 hemiplegia, unspecified affecting left nondominant side I69.35 Hemiplegia and hemiparesis following cerebral infarction Question 7 (1 point) Which of the following is NOT included in the HCC risk adjustment after the CDI process for Case 1, using either the assigned or improved more detailed code set? Question 7 options: 17 37 38 226 Question 8 (1 point) What is the calculated risk adjustment for Major Depressive, Bipolar and Paranoid Disorders HCC in this case using CMS v28? Question 8 options: .451 None .302 .331 Question 9 (1 point) The patient’s problem list for Case 1 lists 5 diagnoses which can be related to diabetes mellitus. However, in our example, the query process only returned Type 2 diabetes with hyperlipidemia and the patient’s A1C is elevated at 6.0. Considering the hierarchy present for the diabetic patients with chronic kidney disease – HCCs, which of these related diagnoses would have more significantly elevated the risk for this patient? Question 9 options: E13.22 I13.0 N18.31 E11.40 Question 10 (1 point) Saved Which of the following is a correct indicator of the HCC assignment for an ICD-10-CM code assigned to panlobular emphysema in CMS esrd hcc v 21? Question 10 options: 4 111 160 226 Part 2 Question 11 (1 point) What is the appropriate ICD-10-CM code utilized to capture the depressive disorder that does not risk adjust under CMS v24 but is returned by the provider after query as “depression, unspecified”: Question 11 options: F4321 F32A F339 F330 Question 12 (1 point) Consider an even more specific diagnosis of Old MI with hypertension with CHF using the code 125.2, I11.0 (replacing the prior hypertension code assignment) and 150.9 to capture heart failure unspecified from the historical problem list. What is the effect on the total risk factor for the patient on this case using CMS v24? Question 12 options: it remains the same it moves up it moves down Question 13 (1 point) What is the demographic factor adjusting this case score prior to the CDI process? Select all that apply. Question 13 options: disability age nicotine dependence gender Question 14 (1 point) What is the demographic factor adjusting this case that is related to the original reason for entitlement? Question 14 options: OREC 99-Unknown status nicotine dependence gender Question 15 (1 point) For Case 2, after entering the revised code set to reflect the most specific codes available and capture the comprehensive reasons for this patient encounter, what is the effect on the RAF using CMS v24? Question 15 options: It increases It decreases It remains the same It cannot be calculated without additional information Question 16 (1 point) Reporting the depression for this patient should include a numbered diagnosis which addresses (select all that apply): Question 16 options: monitoring evaluation assessment treatment DRG assignment CPT code Question 17 (1 point) Which of the following diagnoses is assigned to an HCC for the original provider-based codes for Case 2? Question 17 options: lower abdominal pain, unspecified. Constipation, unspecified. Body mass index (BMI) 24-0-24.9, adult None of the above Question 18 (1 point) Saved Which of the following diagnoses in the proposed query process may not “MEAT” criteria for reporting on this specific encounter specifically related to ongoing treatment? Question 18 options: Old MI hypertension hypercholesterolemia depression Submit Quiz4 of 18 questions saved

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