CPMA UPDATED EXAMS SCRIPT ALL QUESTIONS
AND ANSWERS SURE A+
✔✔A. Qui Tam Relator may receive what type of award for bringing a case on which the
government intervenes?
a. 10-15 percent of the money recovered
b. 15-25 percent of the money recovered
c. 10-15 percent of the total claim amount
d. 15-25 percent of the total claim amount - ✔✔b. 15-25 percent of the money
recovered
✔✔A corporate Integrity Agreement (CIA ) has seven core elements. Which option is
NOT one of the core elements?
a. Provider an implementation report and annual reports to OIG on the status of the
entity's compliance activities.
b. Hire an OIG employee to oversee the compliance efforts
,c. Develop written standards and policies
d. Restrict employment of ineligible persons. - ✔✔b. Hire an OIG employee to oversee
the compliance efforts
✔✔Recovery auditors may perform three types of reviews. What review requires
medical records?
a. Automated
b. Semi Automated
c. Complex
d. Independent - ✔✔d. Independent
✔✔In NCCI edits, what does modifier indicator zero represent?
a. A modifiers is not allowed to bypass the NCCI edits.
b. A modifier may be used to bypass the edits if the documentation supports the
modifier.
c. Modifiers are not applicable to the edits.
d. The NCCI edits is not in effect. - ✔✔a. A modifiers is not allowed to bypass the NCCI
edits
✔✔What is one of the differences between the Stark Law and the Anti-Kickback Law?
a. No intent must be proven for the Stark law; the Anti-Kickback law requires proof of
intention.
b. No intent must be proven for the Anti-Kickback law The Stark law requires proof of
intention.
c. The Stark law refers to fraudulent billing; the Anti-Kickback law refers to remuneration
for self referrals.
d. The Anti-Kickback law refers to fraudulent billing; the Stark law refers to remuneration
for self referrals. - ✔✔a. No intent must be proven for the Stark law; the Anti-Kickback
law requires proof of intention.
✔✔What is another name for the Federal False Claims Act?
,a. Operation Restore Trust
b. Kennedy-Kassebaum Law
c. Lincoln Law
d. Stark Law - ✔✔c. Lincoln Law
✔✔According to this excerpt from the MUE table, which procedure can be reported with
more than two units on the same date of service?
HCPCS/CPT CODE Practitioner Services MUE Values
15758 3
15760 2
15770 2
15775 1
15776 1
15777 1
15780 1
a. 15758
b. 15770
c. 15776
d. 15780 - ✔✔a. 15758
✔✔Recovery auditors may perform three types of reviews. What is an automated
review?
a. Review based solely on the submitted claims and regulatory guidelines. No medical
records are needed.
b. Review based on data and potential human review of a medical record or other
documentation.
c. Medical records are required for review
d. Review is based solely on denials received. - ✔✔a. Review based solely on the
submitted claims and regulatory guidelines. No medical records are needed.
✔✔Which of the following best represents and example of fraudulent activity?
a. Waiving cost-shares or deductibles.
, b. A pattern of claims for services not medically necessary.
c. Failure to maintain adequate medical or financial records.
d. Billing for services at a higher level than provided or necessary. - ✔✔d. Billing for
services at a higher level than provided or necessary.
✔✔What rights does a provider have if he/she disagrees with a demand letter sent by
the OIG?
a. The provider can choose to self-disclose once a demand letter has been received.
b. The provider can send in supporting documentation for the claims to the OIG for
review by certified mail.
c. The provider can only respond to the demand letter with payment.
d. The provider can request a hearing before and ALJ in HHS. - ✔✔d. The provider can
request a hearing before and ALJ in HHS.
✔✔When an IRO is completing a CIA Discovery Sample, how many sampling units are
reviewed?
a. 10
b. 50
c. 100
d. 200 - ✔✔b. 50
✔✔In the NCCI edits, what does modifier indicator one represent?
a. A modifiers is not allowed to bypass the NCCI edits
b. A modifier may be used to bypass the edits if the documentation supports the
modifier.
c. Modifiers are not applicable to the edits.
d. The NCCI edit is not in effect. - ✔✔b. A modifier may be used to bypass the edits if
the documentation supports the modifier.
AND ANSWERS SURE A+
✔✔A. Qui Tam Relator may receive what type of award for bringing a case on which the
government intervenes?
a. 10-15 percent of the money recovered
b. 15-25 percent of the money recovered
c. 10-15 percent of the total claim amount
d. 15-25 percent of the total claim amount - ✔✔b. 15-25 percent of the money
recovered
✔✔A corporate Integrity Agreement (CIA ) has seven core elements. Which option is
NOT one of the core elements?
a. Provider an implementation report and annual reports to OIG on the status of the
entity's compliance activities.
b. Hire an OIG employee to oversee the compliance efforts
,c. Develop written standards and policies
d. Restrict employment of ineligible persons. - ✔✔b. Hire an OIG employee to oversee
the compliance efforts
✔✔Recovery auditors may perform three types of reviews. What review requires
medical records?
a. Automated
b. Semi Automated
c. Complex
d. Independent - ✔✔d. Independent
✔✔In NCCI edits, what does modifier indicator zero represent?
a. A modifiers is not allowed to bypass the NCCI edits.
b. A modifier may be used to bypass the edits if the documentation supports the
modifier.
c. Modifiers are not applicable to the edits.
d. The NCCI edits is not in effect. - ✔✔a. A modifiers is not allowed to bypass the NCCI
edits
✔✔What is one of the differences between the Stark Law and the Anti-Kickback Law?
a. No intent must be proven for the Stark law; the Anti-Kickback law requires proof of
intention.
b. No intent must be proven for the Anti-Kickback law The Stark law requires proof of
intention.
c. The Stark law refers to fraudulent billing; the Anti-Kickback law refers to remuneration
for self referrals.
d. The Anti-Kickback law refers to fraudulent billing; the Stark law refers to remuneration
for self referrals. - ✔✔a. No intent must be proven for the Stark law; the Anti-Kickback
law requires proof of intention.
✔✔What is another name for the Federal False Claims Act?
,a. Operation Restore Trust
b. Kennedy-Kassebaum Law
c. Lincoln Law
d. Stark Law - ✔✔c. Lincoln Law
✔✔According to this excerpt from the MUE table, which procedure can be reported with
more than two units on the same date of service?
HCPCS/CPT CODE Practitioner Services MUE Values
15758 3
15760 2
15770 2
15775 1
15776 1
15777 1
15780 1
a. 15758
b. 15770
c. 15776
d. 15780 - ✔✔a. 15758
✔✔Recovery auditors may perform three types of reviews. What is an automated
review?
a. Review based solely on the submitted claims and regulatory guidelines. No medical
records are needed.
b. Review based on data and potential human review of a medical record or other
documentation.
c. Medical records are required for review
d. Review is based solely on denials received. - ✔✔a. Review based solely on the
submitted claims and regulatory guidelines. No medical records are needed.
✔✔Which of the following best represents and example of fraudulent activity?
a. Waiving cost-shares or deductibles.
, b. A pattern of claims for services not medically necessary.
c. Failure to maintain adequate medical or financial records.
d. Billing for services at a higher level than provided or necessary. - ✔✔d. Billing for
services at a higher level than provided or necessary.
✔✔What rights does a provider have if he/she disagrees with a demand letter sent by
the OIG?
a. The provider can choose to self-disclose once a demand letter has been received.
b. The provider can send in supporting documentation for the claims to the OIG for
review by certified mail.
c. The provider can only respond to the demand letter with payment.
d. The provider can request a hearing before and ALJ in HHS. - ✔✔d. The provider can
request a hearing before and ALJ in HHS.
✔✔When an IRO is completing a CIA Discovery Sample, how many sampling units are
reviewed?
a. 10
b. 50
c. 100
d. 200 - ✔✔b. 50
✔✔In the NCCI edits, what does modifier indicator one represent?
a. A modifiers is not allowed to bypass the NCCI edits
b. A modifier may be used to bypass the edits if the documentation supports the
modifier.
c. Modifiers are not applicable to the edits.
d. The NCCI edit is not in effect. - ✔✔b. A modifier may be used to bypass the edits if
the documentation supports the modifier.
