AAPC CRC Certification Sample Questions

The AAPC Certified Risk Adjustment Coder Certification Sample Question Set on this page is designed to familiarize you with the actual AAPC CRC exam format and question types. These sample questions help you understand how questions are structured and what to expect on test day. While they provide a useful starting point, they represent only a limited preview of the real exam experience.

These sample questions are intended for evaluation and familiarization only. To understand exam style, pacing, and reasoning patterns more clearly, we recommend trying our online sample practice environment. If you are preparing for the AAPC Certified Risk Adjustment Coder (CRC) and want to assess your readiness more rigorously, structured, timed, scenario-based practice is recommended. This approach aligns with the cognitive demands and professional expectations typically associated with risk adjustment coders, medical coders, coding compliance and documentation review professionals working in settings such as health plans, provider organizations with risk-based contracts, healthcare vendors and related coding settings.

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The demo introduces core concepts, while full-length premium simulations provide deeper, scenario-based coverage that more closely reflects the actual cognitive demands of the AAPC Certified Risk Adjustment Coder exam, particularly in areas such as ICD-10-CM diagnosis coding, risk adjustment models, clinical documentation review. You can use these sample questions as a starting point, then progress to the AAPC CRC Certification Practice Exam for stronger readiness. Our premium simulations are designed to mirror real exam conditions, helping you refine reasoning, pacing, and decision-making before your official exam attempt.

AAPC CRC Sample Questions:

01. A cardiology note documents: “Infection and inflammatory reaction due to cardiac pacemaker pocket. Erythema and drainage at pocket site. Start antibiotics and refer for device evaluation.” The note does not document endocarditis. Which coding interpretation best reflects the record?
a) Report endocarditis because all pacemaker infections involve the heart valves
b) Report infection or inflammatory reaction due to cardiac pacemaker device as documented
c) Report routine presence of cardiac pacemaker only because the device remains implanted
d) Report cellulitis only and ignore the device relationship

02. A CRC® trainee says, “Once the exact ICD-10-CM code is submitted, the model always pays separately for every code.” The educator explains that risk adjustment models often group diagnosis codes into condition categories. Which correction is most accurate?
a) Every ICD-10-CM code always creates a separate independent payment amount
b) Model categories are assigned by the coder based on personal judgment rather than published mappings
c) Multiple ICD-10-CM codes may map into broader model categories, and payment impact depends on model rules
d) CPT® procedure codes determine HCC grouping more than diagnosis codes

03. A neurology note documents: “Epilepsy, focal seizures, controlled on levetiracetam. No breakthrough seizures since last visit. Continue medication.” The problem list also includes “syncope” from a prior emergency department visit, but syncope is not addressed in the current note. Which coding interpretation is most appropriate?
a) Report epilepsy because it is documented as a current condition managed with medication
b) Report syncope because any prior neurologic symptom supersedes epilepsy
c) Do not report epilepsy because the seizures are controlled
d) Report acute seizure only because the patient takes levetiracetam

04. A 68-year-old male is seen for a Medicare Advantage chronic condition visit. The provider documents: “Type 2 diabetes mellitus with chronic kidney disease. CKD stage 4 followed by nephrology. Atherosclerosis of native arteries of right leg with rest pain; no ulceration or gangrene. Chronic atrial fibrillation on apixaban. History of prostate cancer treated with prostatectomy in 2017, no recurrence. Patient has a permanent urinary urostomy after bladder surgery; stoma healthy. Continue current medications and specialty follow-up.”

Refer to the clinical note above to answer this question. Which condition should be treated as historical rather than current active disease based on the documentation?
a) Chronic atrial fibrillation on apixaban
b) Prostate cancer treated with prostatectomy in 2017, with no recurrence
c) Atherosclerosis of native arteries of the right leg with rest pain
d) Permanent urinary urostomy with healthy stoma

05. A RADV reviewer evaluates a diagnosis of chronic obstructive pulmonary disease submitted for a March 12 encounter. The medical record for March 12 documents hypertension follow-up only. A separate pulmonology note from April 28 documents COPD and inhaler management, but that April encounter was not submitted for the audited date of service. Which audit conclusion is most appropriate for the March 12 submitted diagnosis?
a) COPD is supported because chronic conditions do not require date-specific documentation
b) COPD should be changed to asthma because the later note mentions inhaler therapy
c) COPD is supported for March 12 because it appears in a later record
d) COPD is unsupported for the March 12 encounter because that record does not document the condition

06. A sleep medicine note states: “Morbid obesity with obesity hypoventilation syndrome. BMI 48.6. Patient uses nocturnal BiPAP; continue weight-management program.” The note does not document COPD or obstructive sleep apnea as the primary diagnosis. Which coding interpretation is most appropriate?
a) Report only BMI because the provider did not document a weight-related diagnosis
b) Report COPD because hypoventilation is the same as obstructive lung disease
c) Report morbid obesity with obesity hypoventilation syndrome as documented
d) Report uncomplicated obesity because BiPAP is used only for sleep comfort

07. An infectious disease note states: “Chronic osteomyelitis of left ankle, suppressive antibiotics continued. No acute sepsis. Wound clinic and orthopedics following.” The note does not document cellulitis or amputation status. Which coding interpretation best reflects the documentation?
a) Report cellulitis because antibiotics are continued
b) Report chronic osteomyelitis of the left ankle as documented
c) Report amputation status because orthopedics is following
d) Report sepsis because chronic infection is present

08. A 69-year-old female is seen for a Medicare Advantage annual chronic care visit. The provider documents: “Type 2 diabetes mellitus with diabetic neuropathy, stable on gabapentin. Chronic kidney disease stage 3b followed by nephrology. Peripheral vascular disease, unchanged. Major depressive disorder in full remission, continue maintenance SSRI. History of pulmonary embolism in 2020, completed anticoagulation, no recurrence. BMI 41.2; provider documents morbid obesity and counsels on weight management. Return in six months.”

Refer to the clinical note above to answer this question. Which diagnosis should be excluded from current risk adjustment reporting based on the documentation?
a) CKD stage 3b followed by nephrology
b) Type 2 diabetes mellitus with diabetic neuropathy
c) History of pulmonary embolism with no recurrence
d) Morbid obesity with BMI 41.2 and counseling

09. Two Medicare Advantage members have the same validated HCC diagnoses for the payment year. One member is 68 years old and community-dwelling; the other is 84 years old and has different demographic characteristics recognized by the model. Which statement best explains why their final risk scores may differ?
a) CMS-HCC risk scores can incorporate demographic factors in addition to validated diagnosis categories
b) CMS-HCC risk scores are based only on the number of office visits during the year
c) CMS-HCC risk scores are identical whenever members share the same HCCs
d) CMS-HCC risk scores ignore diagnoses when members are older than 80

10. A behavioral health note states: “Alcohol dependence, uncomplicated, in early remission. Patient attends counseling and denies current use. Continue relapse prevention plan.” The note does not document alcohol intoxication, withdrawal, or alcohol-induced mood disorder. Which coding interpretation is most appropriate?
a) Report alcohol-induced mood disorder because relapse prevention is discussed
b) Report alcohol intoxication because the patient has alcohol dependence
c) Report alcohol dependence in early remission as documented
d) Report alcohol withdrawal because counseling is ongoing

Answers:

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Note: These sample questions are not official exam questions and are intended only for familiarization and study purposes. If you find any typos or data entry errors in these AAPC Certified Risk Adjustment Coder (CRC) sample questions, please let us know by emailing us at feedback@medicoexam.com