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Question No 1

Which of the following is the major difference between MIPS and APMs?

Choose the Choices:

MIPS participation is required by eligible providers (non-participation results in a financial penalty), and APM participation is voluntary.

APM participation is required by eligible providers (non-participation results in a financial penalty), and MIPS participation is voluntary.

MIPS and APM participation is voluntary by eligible providers.

MIPS and APM participation is required of eligible providers.

Question No 2

review] A 76-year-old patient presents for a wellness visit. The patient’s vitals are BP 120/80, T 98.7, R 19, and there are no abnormal findings in the exam. The patient has COPD, home oxygen, anemia, hypertension, diabetes, fatigue, and weakness. The patient’s medications are called into the pharmacy and home health resource of choice. Which of the following is the BEST query option?

Choose the Choices:

Question No 3

A patient with a PMH of DM, GERD, and HTN is seen in the clinic with complaints of stuffy nose, fever, and feeling tired for the past four days. The patient’s medication list includes SSI, Prilosec, and Diovan. The provider documented: “Congestion, fever, malaise, DM, GERD, HTN. Continue OTC medications for congestion and fever. Rest. Return to the clinic in one week if symptoms persist.” Which of the following ICD-10-CM guidelines BEST applies to how this scenario should be coded?

Choose the Choices:

Question No 4

review] A patient returns to a PCP for follow-up care related to a UTI. The provider documents “stage 3 CKD” as determined by a single eGFR of 52 mL/min. Which of the following actions should the CDI specialist take?

Choose the Choices:

Add diagnosis of CKD stage 3 to claim, as it is reportable.

Review CKD staging criteria with provider.

Delete CKD diagnosis from claim as it was not treated during this encounter.

Query for stage 4 CKD.

Question No 5

The table below provides data indicating the use of Major Depressive Disorder (MDD) diagnosis code assignment for years 1 and 2 of an ambulatory CDI program. Based on the data and if the HCC value assigned to MDD was 0.299, which of the following should be inferred?

Choose the Choices:

The number of patients increased with an equal increase in use of MDD specified and a decrease in MDD, unspecified, not impacting future cost benchmarking.

The number of patients increased with an increase in use of MDD specified and a decrease in MDD, unspecified, impacting future cost benchmarking.

The number of patients increased with the difference between MDD specified and MDD, unspecified insignificant, not impacting future cost benchmarking.

The number of patients increased with an increase in use of MDD specified and an increase in MDD, unspecified, impacting future cost benchmarking.

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