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CPMA PRACTICE EXAM A QUESTIONS WITH CORRECT ANSWERS
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CPMA PRACTICE EXAM A QUESTIONS WITH CORRECT ANSWERS
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CPMA QUESTIONS WITHCORRECT ANSWERS
The sJoint sCommission s(JC) srequires sthe sFactors sthat sAffect sLearning smust sbe
sassessed sfor sa shospital sor shospital sowned sphysician spractice sas swell sas sother shealth
scare sfacilities. sWhen sassessing sthis selement swhat sdoes sthis sinclude?
A. sThe spatient's sability sto sread, smethod sof slearning sand sunderstanding.
B. sAny slanguage sor sphysical sdisabilities.
C. sCultural sbeliefs.
D. sAll sthe sabove s- sans--D. sAll sthe sabove
Report scopies sand sprintouts, sfilms, sscans, sand sother sradio slogic sservice simage
srecords smust sbe sretained sfor show slong saccording sto sFederal sRegulations?
A. s10 syears
B. s7 syears
C. s5 syears
D. s3 syears s- sans--C. s5 syears
At swhich spoint sshould sa sprovider srepay sover spayments sreported sby sself-disclosure sto
sthe soffice sof sInspector sGeneral?
A. sMake sthe spayment sto syour scarrier simmediately.
B. sMake sthe spayment sat sthe sconclusion sof sthe sOIG sinjury.
C. sMake sthe spayment sto sthe scarrier sprior sto sthe sself sdisclosure.
D. sMake sthe spayment sto sthe sOIG swith sa sself sdisclosure sreport. s- sans--B. sMake sthe
spayment sat sthe sconclusion sof sthe sOIG sinjury
Which sof sthe sfollowing smay sbe sconsidered sessential selement s(s) sof san soperative
sreport sand swill sallow sfor saccurate scoding?
A. sThe sapproach
B. sThe stype sof sanesthesia srequired
C. sThe slocation sand sseverity sof swounds srepaired
,D. sAll sof sthe sabove s- sans--D. sAll sof sthe sabove
Which sof sthe sfollowing sis sNOT sa scovered sentity sunder sHIPPA?
A. sPhysician
B. sHealth sPlan
C. sHealth sCare sConsultant
D. sPhysician sAssistant s- sans--C. sHealth sCare sConsultant
When sreferring sto sthe sauthentication sof sa smedical srecord sentry, swhat sdoes sthis sentail?
A. sLegible ssignature sof sauthor sand sdate ssigned
B. sA sphysician's sorder sfor sancillary sservices
C. sAn soriginal sdocument sfiled sin sthe srecord s
D. sThe spatient's spersonal sinformation s- sans--A. sLegible ssignature sof sauthor sand sdate
ssigned
What sis sthe stime slimit smandated sby sCMS sfor sadding sa slate sentry sto sthe smedical
srecord?
A. sOne sWeek
B. sOne sMonth
C. sOne sYear
D. sNo stime slimit s- sans--D. sNo stime slimit
When sshould sa sABN sbe ssigned?
A. sPrior sto sperforming sa sstatutorily sexcluded sprocedure sfor sa sMedicare sbeneficiary.
B. sPrior sto sperforming sa sprocedure sthat smay sbe sdenied sdue sto smedical snecessity sfor
sa sMedicare sbeneficiary.
C. sPrior sto ssubmitting sa sclaim sto sMedicaid sfor sa snon- sservice.
D. sAfter sperforming sa sprocedure sand sfinding sit sis sdenied. s- sans--B. sPrior sto sperforming
sa sprocedure sthat smay sbe sdenied sdue sto smedical snecessity sfor sa sMedicare
sbeneficiary.
Under sa sCorporate sIntegrity sAgreement s(CIA), show smany sclaims smust sbe srandomly
sselected sto sreview sto sdetermine sthe sfinancial serror srate?
A. s15
B. s50
C. s75
D. s100 s- sans--B. s50
,When susing sLCDs sand sCMS sprogram sGuidance sas sa sresource sfor san saudit, swhat
sshould sthe sauditor skeep sin smind?
A. sQICs sare sbound sby sNCDs, sLMRPs, sand sCMS sProgram sguidance, sbut sALJs sand
sMACs sare snot.
B. sLocal scarriers sand sQICs sare sbound sby sLCDs sand sLMRPs
C. sLocal scarries sfollow sLCDs, sLMRPs, sand sCMS sprogram sguidance, sbut sQICs, sALJs,
sand sMACs sare snot sbound sby sthem.
D. sLocal sCarriers, sQICs, sALJs, sand sMACs sare sall sbound sby sNCDs sand sCMS sprogram
sguidance. s- sans--C. sLocal scarries sfollow sLCDs, sLMRPs, sand sCMS sprogram sguidance,
sbut sQICs, sALJs, sand sMACs sare snot sbound sby sthem.
When sreporting sthe sclaims sreview sfindings sunder sa sCIA saudit, sthe sIndependent
sReview sOrganization s(IRO) smust sprovide:
A. sA sdetailed sanalysis slisting sthe spatient sfiles sreviewed sand sfindings sand sprevious
saudit sdisclosures sfor sall sservices
B. sA sdetailed sreport swith sa snarrative sexplanation sof sfinding sand ssupporting srationale
sapproved sby sthe sproviders sattorney.
C. sA sdetailed sreport swith san sanalysis sand snarrative sexplanation swith sfindings sand
ssupporting srationale sregarding sthe sclaim sreview, sincluding sthe sresults sof sthe sdiscovery
sor sfull ssample.
D. sA slist sof sdata sreviewed sand sfindings sin sa snarrative sform s- sans--C. sA sdetailed sreport
swith san sanalysis sand snarrative sexplanation swith sfindings sand ssupporting srationale
sregarding sthe sclaim sreview, sincluding sthe sresults sof sthe sdiscovery sor sfull ssample.
Which sstatement sis smost saccurate sregarding sNCCI?
A. sNCCI sare snational scoding sguidelines sand smust sbe sfollowed sregardless sof sthe
sinsurance scarrier.
B. sYou sneed sto scheck sindividual scarriers sto ssee sif sthey sfollow sNCCI sor sif sthey shave
stheir sown sset sof sbundling sedits.
C. sEach sindividual scarrier swill shave sits sown sbundling sedits sand swill snot suse sNCCI.
D. sNCCI sedits sare ssuggested sways sto sbundle sprocedure scodes, sbut sare snot
snecessary sto sreview sduring san saudit. s- sans--B. sYou sneed sto scheck sindividual scarriers
sto ssee sif sthey sfollow sNCCI sor sif sthey shave stheir sown sset sof sbundling sedits.
, A sprovider srequest syou sto sperform san saudit sof sclaims sthat shave sbeen sdenied spayment
sby sXYZ sinsurance. sSince sthe sphysician scontracted swith sXYZ sinsurance, sall sclaims
ssubmitted sthat sinclude sthe sE/M sservice sand sEKG sinterpretation son sthe ssame sday
shave sbeen sdenied sfor sthe sEKG sinterpretation. sYou sreview sthe smedical srecord sand sthe
sEOB sand sdetermine sthe sservices sare sdocumented sand scoded scorrectly. sWhich sof sthe
sfollowing sitems swill syou sneed sto scomplete syour saudit?
A. sProvider scontract swith sXYZ sinsurance.
B. sProvider sinternal sbilling spolices.
C. sRAC sstatement sof swork
D. sOIG swork splan sfor sthe scurrent syear. s- sans--A. sProvider scontract swith sXYZ
sinsurance.
According sto sthe s"OIG sCompliance sProgram sfor sIndividual sand sSmall sGroup sPhysician
sPractices," sThere sare sessential selements sfor sa scompliance splan. sThese selements
sincluded:
A. sMandatory semployment sof san sinternal sauditor
B. sConduct sappropriate straining sand seducation
C. sDisciplinary saction sfor semployees swho sfile sa squi stam ssuit
D. sDevelop san seffective sE/M sAudit sTool swith sreproducible sresults. s- sans--B. sConduct
sappropriate straining sand seducation
John spresents stoday sfor shis syearly sphysical sand sduring sthe sencounter she salerts shis
sphysician sto ssome sabdominal sissues she shas sbeen shaving sincluding ssharp spains sthat
scome sand sgo sand shave sbeen sincreasing sin sseverity sespecially safter seating. sAfter
sexamination sthe sdoctor sorders san sultrasound swhich sis sperformed sin sthe soffice sand
smedications sand sschedules sa sfollow-up sfor stwo sweeks. sWhat sis sthe sappropriate
smodifier sfor sthis sencounter?
A. sNo smodifier snecessary
B. s25
C. s57
D. s24 s- sans--B. s25
Which sof sthe sfollowing saccurately sdescribes sthe sfinancial simpact sfor sappending
smodifier s24 sto san sE/M sservice sperformed sduring sthe sglobal speriod sof sa smajor
ssurgery?
A. sThe sE/M sservice swill snot sbe spaid swhen sperformed sduring sthe sglobal speriod.
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