Certified Risk Adjustment Coder (CRC)

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Test your knowledge as a Certified Risk Adjustment Coder (CRC) with our comprehensive quiz. With hints and detailed explanations, enhance your understanding and prepare effectively for the CRC exam!

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A patient is seen for diabetes and hypertension. The patient had pneumonia which was resolved three months ago. What diagnoses would be coded?

Diabetes and hypertension
Pneumonia
Diabetes, hypertension and pneumonia
Diabetes

The correct answer is: Diabetes and hypertension

The focus in coding for this situation is on the current conditions that require ongoing management or treatment. In this case, diabetes and hypertension are chronic conditions that are important to document because they affect the patient’s overall health status and require regular monitoring and treatment. The pneumonia, although previously diagnosed, has resolved and is no longer a current problem that affects the patient's ongoing care. Therefore, coding it is not necessary in this scenario. Medical coding guidelines emphasize that only active conditions should be coded, and since the pneumonia has been resolved for three months, it does not meet the criteria for inclusion in this instance. Therefore, the appropriate diagnoses to be coded are diabetes and hypertension, as these are the active conditions that will require continued management.