Cpma exam chapter 3 2024 - Study guides, Class notes & Summaries
Looking for the best study guides, study notes and summaries about Cpma exam chapter 3 2024? On this page you'll find 14 study documents about Cpma exam chapter 3 2024.
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CPMA- Chapter one exam Questions and Answers
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CPMA- Chapter one exam Questions and Answers 
In the NCCI edits, what does modifier indicator nine (9) represent? 
A modifier may be used to bypass the edits if the documentation supports the modifier. 
B. A modifier is not allowed to bypass the NCCI edits. 
C. Only modifier 59 can be used to bypass the edit. 
D. Modifiers are not applicable to the edits, the NCCI edit is not in effect. - Answer-D. 
Modifiers are not applicable to the edits, the NCCI edit is not in effect. 
Rationale: The Correc...
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CPMA Exam Chapter 3 Study Guide with Verified Solutions
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CPMA Exam Chapter 3 Study Guide with Verified 
Solutions 
Accurate reimbursement begins with - Answer-accurate coding and rules that vary by payer 
The CPT codebook contains - Answer-instructions, coding guidelines, parenthetical notes, 
and symbols to provide guidance for proper coding. 
Not all payers follow CPT coding guidelines. - Answer-An auditor must be able to apply 
payer variations to the CPT guidelines during an audit, and must communicate the differences in 
a way that will make sens...
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Chapter 5 CPMA Exam: Contract-based Commercial Insurance Plans Questions and Answers
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Chapter 5 CPMA Exam: Contract-based 
Commercial Insurance Plans Questions 
and Answers 
Most common commercial insurance plans are - Answer-contract based 
That is, benefits arise primarily under a contract between the insurance company and the 
subscriber/patient 
Where the healthcare provider is in network, - Answer-the provider agrees to abide by 
certain rules in a separate contract.. 
The auditor must review the contract to determine the rules the provider is bound to follow 
For commercial...
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CPMA Exam Chapter 5: Self-Disclosure Audits Study Guide
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CPMA Exam Chapter 5: Self-Disclosure 
Audits Study Guide 
The OIG Self-Disclosure Protocol (SDP) provides the - Answer-ability to self-disclose 
potential instances of fraud involving federal healthcare programs for which liability arises 
under the OIG's civil money penalty authorities 
The SDP (Self-Disclosure Protocol) is not for reporting of - Answer-potential or actual Stark 
(self-referral) violations; 
It is not a means to obtain an advisory opinion to determine if the suspect conduct ...
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