AAPC Certified Risk Adjustment Coder (CRC) Examination Practice Test
Risk adjustment coding connects documented diagnoses to the patient’s health status for a reporting period. CRC practice topics represented here include evaluating whether conditions are current and relevant to the encounter, applying ICD-10-CM conventions, and distinguishing documented relationships from assumptions. Accurate work depends on reading the full clinical record and selecting codes supported by provider documentation.
Exam overview
About the AAPC Certified Risk Adjustment Coder (CRC) Examination Exam
A risk adjustment coder reviews encounter notes and other applicable records to identify diagnoses that are documented, supported, and pertinent to the reporting context. This involves checking whether a condition was assessed, treated, monitored, or otherwise addressed; resolving insufficient specificity through appropriate documentation processes; and applying conventions for combination codes, additional codes, and documented causal relationships. Practical decisions include distinguishing a current condition from a history or resolved status, avoiding unsupported links between conditions, and recognizing when a problem-list entry alone does not establish reportability for an encounter. An auditable result should connect each selected code to clear record evidence and preserve the reasoning used to interpret the documentation. Practice scenarios also address chronic disease details and complications, such as diabetes manifestations, kidney-disease-associated anemia, and the status of treated hepatitis C.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A record documents a current diagnosis of chronic hepatitis C, and the provider also documents that the patient completed antiviral treatment and achieved a sustained virologic response. What should the coder do before assigning a current infection code?
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Correct answer: BTreatment history and laboratory findings alone should not substitute for the provider’s current diagnostic assessment. Determine whether active disease, resolved infection, or another status is documented and apply the applicable code-set guidance.
A provider documents chronic obstructive pulmonary disease (COPD) and an acute lower respiratory infection, but does not state that the infection caused an acute exacerbation of COPD. What should the coder do?
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Correct answer: DThe presence of an infection or increased treatment does not by itself establish a documented COPD exacerbation. Code what is supported and query when clarification is needed and appropriate.
A patient’s medical record documents long-term use of insulin for type 2 diabetes. What is the general coding consideration?
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Correct answer: BLong-term medication status may be reported with an additional status code when supported and applicable. Treatment with insulin does not, by itself, change a documented type 2 diabetes diagnosis to type 1.
A patient has a documented diagnosis of type 2 diabetes mellitus, and the provider separately documents diabetic retinopathy with macular edema. What is the most appropriate general coding approach?
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Correct answer: BICD-10-CM diabetes coding may require a combination code for the diabetes complication together with an additional code to describe a specific manifestation or detail, as directed by the Tabular List. The documented relationship and code instructions should be followed.
A patient’s problem list includes hypertension, but the current assessment does not address it and the provider does not document it as affecting care during the encounter. What is the most appropriate coding principle?
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Correct answer: CA diagnosis generally must be supported by documentation and meet applicable reporting criteria for the setting. A carried-forward problem-list entry alone may not establish that the condition was evaluated, treated, or otherwise relevant.
A provider documents a current diagnosis of anemia and explicitly attributes it to chronic kidney disease. What coding principle is relevant?
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Correct answer: AWhen the provider documents a relationship between conditions, combination-code conventions and any Tabular List instructions may apply. The coder should follow official code instructions and not independently establish causation from test results.
A provider documents that a patient has a specific condition, but the record does not include enough detail to choose among the code options shown in the Tabular List. What is the most appropriate response?
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Correct answer: CCode specificity must be supported by documentation. If the documentation does not establish a more specific subtype, do not infer one from treatment or assumptions. Use an appropriate unspecified code when permitted, or follow clarification procedures as applicable.
How to use this practice test
The free US Practice Tests practice session draws up to 20 random questions from the 50-question CRC bank. Submit your answers to see results after the session, then revisit any missed items by checking the documentation principle or coding decision involved.
Preparation tips
- For each case, identify the exact note section showing whether a diagnosis was assessed, treated, monitored, or otherwise addressed during the encounter.
- Separate provider-documented causal relationships from conditions that merely appear together; do not infer a linkage when the record does not establish one.
- When a diagnosis lacks detail needed for code selection, identify the missing specificity and the appropriate documentation follow-up rather than guessing.
- Compare current-condition documentation with history, resolved-status, and treatment-status language, especially in cases involving infection or chronic disease.
- For diabetes and other chronic conditions, trace each documented manifestation or complication to the applicable ICD-10-CM conventions and supporting record evidence.