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Documentation from which of the following facility settings contributes to the CMS-HCC risk score?
A female patient presents for her yearly wellness check-up. Her vital signs are within normal limits
with the exception of dyspnea. Her weight is 165 lbs, up 10 lbs from her previous clinic visit 2 weeks
prior. Problem list includes diagnoses of obesity, COPD, heart failure, and diabetes without
complications. The patients A1c noted 9.2 up from 7.2 from previous year wellness exam. Based on
the clinical indicators, which of the following medications should be evaluated and addressed during
this clinic visit?
If a patient is being seen for follow-up and the documentation indicates that the patient was
admitted to the hospital 28 days ago with an acute cerebral infarction with remaining right-sided
weakness, which of the following diagnoses would be MOST appropriate?
A CDI specialist receives a call from a disgruntled provider regarding recent documentation queries.
The provider claims to only have 15 minutes to see patients and does not have time for interruptions
like this if it does not increase reimbursement. Which of the following is the BEST course of action to
effectively facilitate communication?
A provider has been determined to be a high-cost provider after a total claims cost analysis. The
providers patient panel has an overall low HCC average score. Which of the following is the MOST
likely explanation regarding the low HCC average score?
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