CRC Risk Adjustment Coding study guide

The Certified Risk Adjustment Coder (CRC) credential, offered by AAPC, validates expertise in risk adjustment coding - specifically, applying ICD-10-CM diagnosis codes to capture the complete health status of patients in value-based care models. It is designed for new entrants to medical coding who want to start in risk adjustment and value-based care, experienced but uncertified coders seeking to validate their skills, certified coders expanding into risk adjustment and HCC coding, and healthcare professionals working with payers, provider groups, or organizations involved in value-based care. The exam covers four domains: core risk adjustment knowledge (including Hierarchical Condition Categories and payment systems such as Medicare Advantage and ACA marketplace plans); application of ICD-10-CM codes for chronic and complex conditions such as diabetes, COPD, cancer, cardiovascular disease, and renal disease; documentation and compliance, including reviewing provider documentation for specificity and applying CMS compliance standards; and auditing and data accuracy, including chart reviews to confirm documentation supports reported HCCs. AAPC states that candidates need a high-level knowledge of medical terminology, anatomy, and pathophysiology, along with an understanding of proper ICD-10-CM diagnosis code application for risk adjustment coding. The CRC Risk Adjustment Coding study guide has 4 sections and about 1,670 words.