CMS Risk Adjustment Data Validation (RADV) Practice Exam

Chart abstraction in RADV is the careful review of a patient’s medical records to identify all diagnoses that should affect the Risk Adjustment Factor, along with when those conditions started or were active and the evidence that supports them. Abstractors comb through provider notes, test results, imaging, treatment plans, and other documentation to confirm that a condition is present during the measurement period and that there is concrete evidence linking it to the appropriate risk-adjustment category. This process ensures the diagnoses used to calculate the RAF are properly supported, reproducible, and auditable, which helps prevent payment errors and maintains accuracy in risk-adjusted payments. While clinicians contribute to the documentation, chart abstraction relies on trained abstractors or coders who pull and verify the information from the medical record, rather than simply assigning RAF from diagnosis lists or conducting patient interviews.