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CPMA PRACTICE TEST QUESTIONS AND ANSWERS
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CPMA PRACTICE TEST QUESTIONS AND ANSWERS
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CPMA PRACTICE TEST QUESTIONSAND ANSWERS
The first initial, last name and credentials - Answer-What is the minimum signature
assignment(s) of the author of an entry in the medical record?
Personal biographical data and consent for treatment or authorization for treatment form
- Answer-Based on Joint Commission accreditation guidance for personal data, what
two elements must be evident in the medical record
Surgical assistants - Answer-As an auditor, who of the following would NOT be
expected to submit operative notes?
Discard it in a locked shredding receptacle - Answer-What is the appropriate way to
dispose of PHI that is no longer needed?
Far enough in advance that the beneficiary or representative has time to consider the
options and make an informed decision - Answer-When must ABNs be signed?
For a six (6) year period of time - Answer-Patients can request copies of disclosure of
PHI under HIPAA
Fraud - Answer-A provider knows that an evaluation and management service they
provide on the same date as a major procedure will be bundled, so he submits the claim
for the E/M with a different date of service. This is an example of:
Three times the amount improperly claimed - Answer-For the civil monetary penalties,
for false or fraudulent claims, up to how many times of the amount damages are for
each false claim submitted?
Physician Tax Issues - Answer-Which type of case is not prosecuted under the federal
false claims act?
5% - Answer-A full sample must be reviewed and a systems review must be conducted
when the net financial error rate of the sampling equals or exceeds what percent?
Only physicians who refer Medicare and Medicaid patients to entities for designated
health care services with which the provider or immediate family member has a financial
relationship - Answer-The Stark Statute applies to...
If a RAC can demonstrate a high level of error, the RAC can then extrapolate the
findings and request a refund. - Answer-When can a RAC extrapolate the
overpayment(s) on claims?
, 10 records per year, per provider - Answer-What are the recommended number of
charts to audit per provider and the minimum frequency of the audit according to the
OIG Recommended Compliance Plan?
Software used in performing statistical random samples and evaluating results -
Answer-How is RAT-STATS used by an auditor?
Selection of a large number of claims are selected for a review that might be focused on
specific procedure and/or diagnosis codes. - Answer-A comprehensive audit is
Aggregate - Answer-An analysis that provides the organization an overview of the deficit
areas captured by a medical record audit is called what?
Claims review methodology, statistical sampling documentation, and claim review
findings - Answer-What information should be reported to the OIG in the Claims Review
findings as part of an entity's Annual Report?
$5,500 to
411,000 per claim - Answer-What is current False Claim Act penalty?
Up to $25,000 fine and/or imprisonment of up to 5 years - Answer-What is the current
penalty for violating the Anti-Kickback Law?
Range from $10,000-$50,000 per violation and an assessment of up to 3 times the
amount of the over-payments - Answer-Current amount of civil monetary penalties
50 - Answer-How many sampling units are selected for review in a Discovery Sample
under a Corporate Integrity Agreement?
Corporate Integrity Agreements - Answer-Required by the OIG s a condition of not
seeking exclusion from participation when an individual or entity seeks to settle civil
healthcare fraud cases; typically last 5 yrs but can be longer; most have the same core
requirements along with specific steps for the individual or entity that are related to the
conduct that led to the settlement
A modifier is not allowed and will not bypass edits - Answer-What is a Correct Coding
Indicator of 0?
A modifier is allowed and will bypass edits - Answer-What is a Correct Coding Indicator
of 1?
The use of a modifier is not specified - Answer-What is a Correct Coding Indicator of 9?
Identify improper payments made on claims of healthcare services provided to Medicare
beneficiaries - Answer-The Goal of the Recovery Audit Contractor program is to
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