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CPCO Final Exam prep | 40 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
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CPCO Final Exam prep | 40 Questions with 100% Correct Answers | Latest Update 2024 | Rated A+
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CPCO Final Exam prep | 40 Questions with 100%Correct Answers | Latest Update 2024 | Rated A+
Modifiers provide the means by which a physician practice can indicate a service or procedure that
has been performed has been altered by some specific circumstance, but not changed in its
definition or code. Assuming the modifier is used correctly and appropriately, this specificity
provides the justification for payment for those services. The OIG recently published information
that modifier ____ was being misused. This modifier is only suppose to be used for
a procedure on a different site or location. - ✔✔59
In addition to keeping a training log, materials, and records, to make sure employees
understand the training content compliance officers should also obtain what from employees? -
✔✔an attestation
John, Compliance Officer for ABC Medical Group told the Board that when conducting a risk
assessment, that coding and billing are considered to be what level of risk to an organization? -
✔✔high
Medical practices should be aware of risks identified in the past and then establish policies
and procedures for what? - ✔✔continual monitoring
John, the Compliance Officer for ABC Family Medical Group, explains to the Board which is
made up of physician owners, that because it is considered the overarching criteria for
determining a level of service, the provider must ensure that the documentation supports
what? - ✔✔medical necessity
, Generally, routine screening procedures done as part of an asymptomatic annual examination
for a Medicare patient are ___________? - ✔✔non-covered services
Sarah , Compliance Officer for Apple Hospital explains to the Board that in general, the
OIG recommends auditing how many medical records per federal payer? - ✔✔5 or more
Steve, Director of Compliance for Small Rural Hospital Group explains to the physicians
that some of the most common reasons for claims not being paid in the current
reimbursement environment are related to _______ - ✔✔Diagnosis Code
Sarah, Compliance Officer for Apple Hospital, explains to the hospital Board that the ______
governs relationships between competitors? - ✔✔Antitrust
Medicare requires that physicians or mid-level providers certify the need for physical,
occupational, and speech therapy. The first certification is needed within how many days of
the patient starting therapy? - ✔✔30
Which screening exam does not require an order, in any setting, but frequently is still
requested by the radiology center? - ✔✔mammogram
Carol, Compliance Officer for XYZ Internal Medial Group needs to hire some physicians when a
few of the owner physicians want to take a long vacation. The short term physicians hired are
called_______. - ✔✔locum tenens
_________ is billing for a more expensive service than the one actually performed. In the
hospital setting, ______ is in the form of using higher rated (paying) diagnostic related group
(DRG) codes. The same can happen in surgical procedures, therapy services, radiology, and
laboratory services. - ✔✔up coding
It is important to explain to the staff that retaliation between employees "I can get Suzie in
trouble because she irritates me and I want her fired" is considered what type of reporting? -
✔✔bad faith
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