Certified Risk Adjustment Coder (CRC^®) Certification Course

Required Code Books

• ICD-10-CM, published in course year

Prerequisite Courses for CPC Training

Because risk adjustment coders must have expert knowledge of diagnoses and diagnosis coding, courses in anatomy, pathophysiology, and medical terminology are essential to CRC certification training. These three courses — or the 3-in-1 course, Foundations in Medicine — are prerequisites for CRC students.

• Anatomy Online Course
• Medical Terminology Online Course
• Pathophysiology Online Course
• Foundations in Medicine

Exemption: If your educational or employment background have provided you with working knowledge of medical terminology, anatomy, and pathophysiology, you are exempt from these prerequisites. 

Computer With:

• High-speed Internet access
• Adobe Acrobat Reader (free download available)
• For best experience, use of a mobile device is not recommended

CRC Certification Course Description

This online course, designed to be completed in 3 months, teaches fundamental risk adjustment coding skills and prepares students to take AAPC's CRC exam.

If choosing the self-paced course, you should plan to complete the program in 3 months. AAPC allows for an additional month, giving you 4 months of online access to course materials. Apart from reading and study time, the CRC Certification Course involves roughly 40 clock hours of course work.

Enrollment in this class includes:

• Coverage of ICD-10-CM coding for all risk adjustment models (HCC, HHS-ACA, CDPS)
• Reading assignments, practice exercises, chapter reviews, module tests, and a final exam
• Online coaching on an individual, as-needed basis

CRC Certification Course Learning Objectives

Students will be equipped both to ensure clinical documentation accurately portrays the patient’s health status and to ensure all clinically documented diagnoses and comorbidities are properly reported.

Certificate of Completion & CEUs

If you currently hold an AAPC certification, you will earn 30 CEUs you can apply to your existing certification by completing this course. CEUs are one-time use only and satisfy requirements for all certifications except CPCO, CIRCC, and CPMA, and specialty certifications.

Successful completion of the CRC Certification Training Course requires:

• A passing score of 70% or higher on all chapter review exams
• A passing score of 70% or higher on final exam
• An overall final course score of 70% or higher

To receive a certificate of completion, students must meet the above requirements and complete the course within the allotted time frame.

Online CRC Certification Course Content

The Business of Medicine

• The role of a risk adjustment coder
• The hierarchy of providers
• The different types of payers
• Medical necessity
• The need for privacy and security
• Fraud and abuse
• Need for compliance rules and audits
• The OIG Work Plan

Medical Terminology and Anatomy Review

• Root words, prefixes, and suffixes
• Integumentary system
• Musculoskeletal system
• Cardiovascular system
• Lymphatic system
• Respiratory system
• Digestive system
• Urinary system  
• Reproductive systems
• Nervous system
• Endocrine system
• Hematologic (hemic) system
• Immune system

Introduction to ICD-10-CM

• Overview of ICD-10-CM layout
• Steps to look up a diagnosis code
• ICD-10-CM Official Guidelines for Coding and Reporting
• Diagnosis coding guidelines for outpatient reporting

Risk Adjustment Models

• Types of risk adjustment models
• Medicare hierarchal condition categories (HCC)
• The Health and Human Services (HHS) Hierarchical Condition Category Model
• Medicaid Chronic Illness and Disability Payment System (CDPS)
• Hybrid model

Predictive Modeling & Quality of Care

• CMS Stars Ratings Program
• Healthcare Effectiveness Data and Information Set (HEDIS®)
• National Quality Forum
• The Quality Payment Program

How Risk Adjustment Relates to Medical Financial Matters

• New beneficiary calculations
• Annual risk adjustment audits
• Accountable Care Organizations
• Placing providers “at-risk”

Diagnosis Documentation & Coding

• Data collection sources
• Coding for all diagnoses noted in a date of service (DOS)
• Evaluation and management coding
• Coding Diagnoses from chief complaint (CC) or history of present illness (HPI)
• Coding diagnoses from PMH and other historical lists
• Coding diagnoses from review of systems (ROS)
• Coding diagnoses from the exam portion of a record
• Coding from assessment and plan

Clinical Documentation Barriers

• Signature or credential issues
• Signatures in Risk Adjustment Data Validation (RADV or HRADV)
• Past medical history
• Lab and test results
• Status conditions
• Signs and symptoms
• Uncertain diagnosis
• Coding clinic guidance
• Risk adjustment diagnosis coding steps

CRC Certification Course Policy

This 40-clock hour course should be completed within 3 months, but you are given an additional month or 4-month access to the class from date of purchase. Date of purchase is considered your course start date, with additional time allotted for processing your order. You will receive email instruction on course access once your order is processed.

• If you need more time to complete your studies, you may purchase time extensions for a monthly fee.
• If you purchased a CRC exam voucher in your training package, your voucher is valid for 12 months from date of purchase. 
• Membership is required to take any AAPC examination.

By purchasing any online course and other items, I certify that I have read and agree to the online course Terms and Conditions, the Course Requirements, and the Refund Policy.