• 57 questions

Certified Risk Adjustment Coder Practice Test

Unofficial CRC exam practice: diagnosis coding, risk adjustment models, compliance and short cases, every answer sourced.

In ICD-10-CM, which stage of chronic kidney disease equates to severe CKD?

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Exam mode: 50 questions, 120 minutes, 35 right to pass (70%).

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Unofficial practice questions, not affiliated with AAPC. Bank checked October 12, 2026.

The real exam, as AAPC describes it

Questions
100
To pass
70 of 100 right (70%)
Time limit
240 minutes
Format
Multiple choice; the last 10 are cases
Domains
Diagnosis coding 30, compliance 15, models 15, documentation 12
Other domains
Purpose of models 10, cases 10, terminology 5, quality 3
Code book
One ICD-10-CM book, print or eBook
Where
Online with a live proctor, or a testing center
Results
In 7 to 10 business days

Checked October 12, 2026 against AAPC, Taking the CRC exam: What to expect on exam day, Passing grades and Breakdown of the 100-question CRC exam. Rules change, so confirm with the agency itself before your test.

AAPC's own CRC exam page

Next step Medical terminology practice testCCS practice test

All 57 questions

Compliance 9

  • An internal review finds diagnosis codes sent to CMS that do not meet risk adjustment submission requirements. What is the plan sponsor responsible for? Medicare Managed Care Manual, Chapter 7, section 40
  • An MA organization identifies that it received an overpayment. By when must it report and return it? 42 CFR 422.326, paragraph (d)
  • For the validation of risk adjustment data, what must MA organizations and their providers submit when CMS requires it? 42 CFR 422.310, paragraph (e)
  • How far back does the look-back period for returning Medicare Advantage overpayments reach? 42 CFR 422.326, paragraph (f)
  • In risk adjustment data validation for Affordable Care Act plans, who performs the initial validation audit? 45 CFR 153.630, paragraph (b)(1)
  • Under the False Claims Act, which state of mind counts as acting "knowingly"? 31 U.S.C. 3729, subsection (b)(1)
  • What does CMS confirm during a Medicare Advantage RADV audit? CMS, Medicare Advantage Risk Adjustment Data Validation Program, About the Program
  • What must the compliance program of an MA organization include? 42 CFR 422.503, paragraph (b)(4)(vi)
  • Why are diagnoses from a diagnostic radiology service not acceptable for Medicare risk adjustment? Medicare Managed Care Manual, Chapter 7, section 120.1.1
Show all 57 questions (48 more)

Diagnosis coding 17

  • A condition was treated in the past and no longer exists. How is it handled on today's outpatient encounter? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section IV.J
  • A myocardial infarction healed long ago and needs no further care. Which code may be assigned? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.e
  • A patient is seen four times in a year for ongoing care of heart failure. On how many of those encounters may the heart failure be reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section IV.I
  • A problem list shows type 2 diabetes managed with a daily tablet of an oral hypoglycemic drug and nightly insulin. How is the long-term drug use reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.4.a.3
  • A provider documents hypertension and chronic kidney disease without linking them. How are they coded? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.a
  • Assessment: hypertension, chronic systolic heart failure and stage 3 chronic kidney disease. Which category leads the coding? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.a.3
  • Coronary atherosclerosis with angina pectoris is coded with a combination code from subcategory I25.11. Is a separate angina code also needed? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.b
  • Hemiparesis of the right side is documented, with no word on which hand is dominant. What is the default? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.6.a
  • The history section lists a stroke in the past. The exam finds no weakness, speech problem or other deficit. Which code fits? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.d.3
  • How does a status code differ from a history code? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.21.c.3
  • In an outpatient note, a diagnosis is written as "probable". How is it coded? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section IV.H
  • In the guidelines for COPD and asthma, what is an acute exacerbation? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.10.a.1
  • Prostate cancer was removed eight years ago. The note says there has been no treatment since and no sign of the disease. What does the coder report for it? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.2.d
  • The record documents both chronic kidney disease, stage 5, and end stage renal disease. Which code is assigned for the kidney disease? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.14.a.1
  • The record says "diabetes mellitus" and does not give the type. Which category is the default? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.4.a.2
  • The vital signs show a body mass index of 41. The provider's assessment says nothing about weight. Can the BMI code be reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.21.c.3
  • Which category reports the status of a patient who has lost a leg below the knee? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.21.c.3

Cases: code the record 5

  • Follow-up visit. Cerebral infarction two years ago with residual right-sided hemiparesis. The patient is right-handed. Which code is reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.d.1
  • Office note. Assessment: 1. Hypertension. 2. Chronic kidney disease, stage 4. Nothing says the kidney disease has another cause. Which codes are reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.9.a.2
  • Office note. Assessment: diabetes with diabetic polyneuropathy, on insulin. The type of diabetes is not stated. Which codes are reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.4.a.3
  • Office note. Colon cancer was resected six years ago. No treatment since. Surveillance colonoscopy is normal, with no evidence of disease. Which code is reported for the cancer? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.2.d
  • Office visit. Assessment: chronic cough, probable COPD. Plan: spirometry. Which code is reported? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section IV.H

Documentation improvement 7

  • A chart reviewer thinks the laboratory values fall short of a textbook definition of a diagnosis the provider documented. On what is code assignment based? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.A.19
  • A progress note reads "diabetes resolved after weight loss". What should the coder do before reporting the diabetes as in remission? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.4.a
  • A wound care nurse's note gives a sacral pressure ulcer as stage 3. The provider's note documents the pressure ulcer without a stage. What may be coded? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.B.14
  • For Medicare risk adjustment, a submitted diagnosis must be documented in the medical record as the result of what? Medicare Managed Care Manual, Chapter 7, section 40
  • Two entries in the medical record conflict about a diagnosis. What do the guidelines direct? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.A.19
  • What do the guidelines call essential for complete and accurate documentation and code assignment? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Introduction
  • When is a condition that follows surgery coded as a complication of care? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.B.16

Pathophysiology, terminology and anatomy 3

  • In ICD-10-CM, which stage of chronic kidney disease equates to severe CKD? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.C.14.a.1
  • What does HCC stand for in risk adjustment? 42 CFR 422.2, definitions
  • What is a sequela? ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section I.B.10

Purpose and use of risk adjustment models 6

  • How did CMS use diagnoses to build the CMS-HCC model? Medicare Managed Care Manual, Chapter 7, section 70.1
  • How does the CMS-HCC model treat certain combinations of coexisting diagnoses that raise costs more than their separate factors suggest? Medicare Managed Care Manual, Chapter 7, section 70.2.7
  • Two HCCs in the same disease hierarchy are reported for one beneficiary. On which is Part C payment based? Medicare Managed Care Manual, Chapter 7, section 70.2.6
  • What does risk adjustment let CMS do when it pays Medicare Advantage plans? Medicare Managed Care Manual, Chapter 7, section 20
  • What does the normalization factor do to risk scores? Medicare Managed Care Manual, Chapter 7, section 90
  • Why does CMS apply a separate MA coding adjustment to Part C risk scores? Medicare Managed Care Manual, Chapter 7, section 100

Quality of care 2

  • Which rating system does CMS use for the overall rating of a Medicare Advantage contract? 42 CFR 422.162, paragraph (b)(1)
  • Which statement describes HEDIS as the Medicare Advantage rules define it? 42 CFR 422.162, paragraph (a)

Risk adjustment models 8

  • For which organizations is the frailty adjuster part of risk adjusted payment? Medicare Managed Care Manual, Chapter 7, section 80
  • In the Affordable Care Act risk adjustment program, which markets hold the "risk adjustment covered plans"? 45 CFR 153.20, definitions
  • Which are the three segments of the CMS-HCC ESRD model? Medicare Managed Care Manual, Chapter 7, section 70.3
  • Which beneficiaries does CMS identify as new enrollees for the CMS-HCC model? Medicare Managed Care Manual, Chapter 7, section 70.2.1
  • Which model adjusts Medicare Part D payments to drug plans? Medicare Managed Care Manual, Chapter 7, section 70.4
  • Which of these is a demographic variable in the CMS-HCC model? Medicare Managed Care Manual, Chapter 7, section 70.2.3
  • Which program is the Chronic Illness and Disability Payment System (CDPS) widely used for? UC San Diego, Chronic Illness and Disability Payment System (CDPS), opening
  • Who counts as long-term institutionalized in the CMS-HCC model? Medicare Managed Care Manual, Chapter 7, section 70.2.1

How this list was compiled: Our own questions, written to the domains of the breakdown of the 100-question Certified Risk Adjustment Coder (CRC) exam that AAPC publishes (https://www.aapc.com/certifications/crc/taking-the-crc-exam, read 2026-10-12): compliance 15 questions, diagnosis coding 30, documentation improvement 12, pathophysiology/medical terminology/anatomy 5, purpose and use of risk adjustment models 10, quality of care 3, risk adjustment models 15, and 10 cases. The bank holds 9, 17, 7, 3, 6, 2, 8 and 5 questions. Every fact was read on 2026-10-12 in the public source the question names: the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (https://www.cms.gov/files/document/fy-2027-icd-10-cm-coding-guidelines.pdf) and the 2027 Code Descriptions in Tabular Order (from https://www.cms.gov/medicare/coding-billing/icd-10-codes); the Medicare Managed Care Manual, Chapter 7, Risk Adjustment (Rev. 118; https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/mc86c07.pdf); the CMS page on the Medicare Advantage Risk Adjustment Data Validation Program; federal regulations in the eCFR text of 2026-09-01 (42 CFR 422.2, 422.162, 422.310, 422.326, 422.503; 45 CFR 153.20, 153.630); the False Claims Act, 31 U.S.C. 3729; and the page of the University of California San Diego on the Chronic Illness and Disability Payment System. Licence: Questions, choices and explanations are original work of this site.

How it works

This free Certified Risk Adjustment Coder practice test has 57 questions of our own in the domains of the CRC exam. Unofficial: not affiliated with or endorsed by AAPC.

Read the full guide

What the questions follow

AAPC's breakdown of the CRC exam, read October 12, 2026, domain by domain. Most questions are coding scenarios, and the cases give a short note to code.

Where the answers come from

Coding answers cite the FY 2027 ICD-10-CM Official Guidelines and code descriptions. Model and audit answers cite the Medicare Managed Care Manual, Chapter 7, the federal rules for Medicare Advantage and the marketplace (42 CFR 422, 45 CFR 153) and the False Claims Act.

Timing and pass mark

Exam mode asks 50 questions in 120 minutes, half of the real exam at its pace, and marks a pass at 70%, the score AAPC requires.

  • Work the cases with your own ICD-10-CM code book open, as on the real exam.
  • CMS publishes the hierarchies of a recalibrated model in its Rate Announcement, so check the model version for your exam year.

Questions and answers

Are these certified risk adjustment coder exam questions from the real exam?

No. Every question is our own, written from the federal coding guidelines, CMS manuals and regulations. None is copied or reworded from the AAPC exam, its practice exams or its study guide.

How many questions are on the CRC exam?

100 multiple-choice questions in one four-hour sitting, by the AAPC exam page. The last ten are cases that test coding diagnoses from a medical record.

What is the passing score for the CRC exam?

70%, which is at least 70 of the 100 questions right, by the AAPC exam page. A result here is practice only and is not a forecast of the real exam.

Is the CRC exam open book?

Yes. AAPC allows one ICD-10-CM code book from any publisher, in print or as an eBook inside the exam platform. It is the only code book allowed.

Is there a certified risk adjustment coder study guide PDF?

This page is a question bank, not a study guide. After a set, Print opens a question sheet, with its answer key if you tick the box, and the print window of your browser can save it as a PDF.

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