2
AAPC CPMA Practice Exam Study questions with verified detailed
|| || || || || || || || ||
answers
What elements must be in a medical record - ✔✔Patient ID, Assignment of Benefits,
|| || || || || || || || || || || || || ||
medical history, immunizations, physical exam, lab report, clinical impression, physician
|| || || || || || || || || ||
orders
What is the minimum signature assignment of the author of entry in the medical record? -
|| || || || || || || || || || || || || || || ||
✔✔First initial, Last Name and credentials || || || || ||
Based on the JC accreditation guidelines for personal data, what 2 elements must be evident
|| || || || || || || || || || || || || ||
in the medical record? - ✔✔There must be a patient information sheet that contains
|| || || || || || || || || || || || || || ||
biographical data, name, address, etc. along with authorization for treatment whether it is
|| || || || || || || || || || || || ||
an office visit, diagnostic services or surgical procedure.
|| || || || || || ||
What is the appropriate way to dispose of PHI that is no longer needed? - ✔✔Discard it in a
|| || || || || || || || || || || || || || || || || || ||
locked shredding receptacle || ||
When must ABNs be signed? - ✔✔Far enough in advance that the beneficiary or
|| || || || || || || || || || || || || ||
representative has time to consider the options and make an informed decision. || || || || || || || || || || ||
SOAP and CHEDDAR are two formats of medical record documentation. Which section of
|| || || || || || || || || || || || ||
each format would you find the patient's history? - ✔✔S in SOAP and H in CHEDDAR
|| || || || || || || || || || || || || || ||
Patients can request copies of disclosure of PHI under HIPAA: - ✔✔For a six (6) year period
|| || || || || || || || || || || || || || || ||
of time
|| ||
When can a RAC extrapolate the overpayment(s) on claims? - ✔✔If a RAC can demonstrate
|| || || || || || || || || || || || || ||
a high level of error, the RAC can then extrapolate the findings and request a refund.
|| || || || || || || || || || || || || || || ||
, 2
Example: Column 1 Code/Column 2 Code 45385/45380 CPT Code 45385 - Colonoscopy,
|| || || || || || || || || || || ||
flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s)
|| || || || || || || || || || || || ||
by snare technique CPT Code 45380 - Colonoscopy, flexible, proximal to splenic flexure;
|| || || || || || || || || || || || ||
with biopsy, single or multiple Policy: More extensive procedure Modifier -59 is: - ✔✔Only
|| || || || || || || || || || || || || ||
appropriate if the two procedures are performed on separate lesions or at separate patient
|| || || || || || || || || || || || || ||
encounters.
Is reporting 14000 with 11401 unbundling? - ✔✔Yes according to CPT guidelines the
|| || || || || || || || || || || || ||
excision of a benign lesion or malignant lesion is not separately reportable.
|| || || || || || || || || || ||
Commercial and Government carriers audit medical records. Select the statement that is
|| || || || || || || || || || || ||
TRUE regarding commercial and government carriers. - ✔✔Commercial carriers and
|| || || || || || || || || ||
Government carriers both use claims data to identify providers and services to audit.
|| || || || || || || || || || || ||
A comprehensive audit is: - ✔✔sometimes referred to as a focused review, is an audit of a
|| || || || || || || || || || || || || || || || ||
specified number of medical records in which a previous audit has identified problems
|| || || || || || || || || || || || ||
based on procedure and/or diagnosis codes or other audit findings.
|| || || || || || || || ||
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? - ✔✔10
|| || || || || || || || || || || || ||
records per provider each year || || || ||
True or False: When a CRNA and a Anesthesiologist both have a part in the procedure and
|| || || || || || || || || || || || || || || || ||
belong to the same practice they can both bill on the same claim - ✔✔TRUE
|| || || || || || || || || || || || || ||
What should an auditor review for an operation? - ✔✔The operative note, codes selected,
|| || || || || || || || || || || || || ||
payer payment policy and NCCI edits prior to claim submission
|| || || || || || || || ||
AAPC CPMA Practice Exam Study questions with verified detailed
|| || || || || || || || ||
answers
What elements must be in a medical record - ✔✔Patient ID, Assignment of Benefits,
|| || || || || || || || || || || || || ||
medical history, immunizations, physical exam, lab report, clinical impression, physician
|| || || || || || || || || ||
orders
What is the minimum signature assignment of the author of entry in the medical record? -
|| || || || || || || || || || || || || || || ||
✔✔First initial, Last Name and credentials || || || || ||
Based on the JC accreditation guidelines for personal data, what 2 elements must be evident
|| || || || || || || || || || || || || ||
in the medical record? - ✔✔There must be a patient information sheet that contains
|| || || || || || || || || || || || || || ||
biographical data, name, address, etc. along with authorization for treatment whether it is
|| || || || || || || || || || || || ||
an office visit, diagnostic services or surgical procedure.
|| || || || || || ||
What is the appropriate way to dispose of PHI that is no longer needed? - ✔✔Discard it in a
|| || || || || || || || || || || || || || || || || || ||
locked shredding receptacle || ||
When must ABNs be signed? - ✔✔Far enough in advance that the beneficiary or
|| || || || || || || || || || || || || ||
representative has time to consider the options and make an informed decision. || || || || || || || || || || ||
SOAP and CHEDDAR are two formats of medical record documentation. Which section of
|| || || || || || || || || || || || ||
each format would you find the patient's history? - ✔✔S in SOAP and H in CHEDDAR
|| || || || || || || || || || || || || || ||
Patients can request copies of disclosure of PHI under HIPAA: - ✔✔For a six (6) year period
|| || || || || || || || || || || || || || || ||
of time
|| ||
When can a RAC extrapolate the overpayment(s) on claims? - ✔✔If a RAC can demonstrate
|| || || || || || || || || || || || || ||
a high level of error, the RAC can then extrapolate the findings and request a refund.
|| || || || || || || || || || || || || || || ||
, 2
Example: Column 1 Code/Column 2 Code 45385/45380 CPT Code 45385 - Colonoscopy,
|| || || || || || || || || || || ||
flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s)
|| || || || || || || || || || || || ||
by snare technique CPT Code 45380 - Colonoscopy, flexible, proximal to splenic flexure;
|| || || || || || || || || || || || ||
with biopsy, single or multiple Policy: More extensive procedure Modifier -59 is: - ✔✔Only
|| || || || || || || || || || || || || ||
appropriate if the two procedures are performed on separate lesions or at separate patient
|| || || || || || || || || || || || || ||
encounters.
Is reporting 14000 with 11401 unbundling? - ✔✔Yes according to CPT guidelines the
|| || || || || || || || || || || || ||
excision of a benign lesion or malignant lesion is not separately reportable.
|| || || || || || || || || || ||
Commercial and Government carriers audit medical records. Select the statement that is
|| || || || || || || || || || || ||
TRUE regarding commercial and government carriers. - ✔✔Commercial carriers and
|| || || || || || || || || ||
Government carriers both use claims data to identify providers and services to audit.
|| || || || || || || || || || || ||
A comprehensive audit is: - ✔✔sometimes referred to as a focused review, is an audit of a
|| || || || || || || || || || || || || || || || ||
specified number of medical records in which a previous audit has identified problems
|| || || || || || || || || || || || ||
based on procedure and/or diagnosis codes or other audit findings.
|| || || || || || || || ||
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? - ✔✔10
|| || || || || || || || || || || || ||
records per provider each year || || || ||
True or False: When a CRNA and a Anesthesiologist both have a part in the procedure and
|| || || || || || || || || || || || || || || || ||
belong to the same practice they can both bill on the same claim - ✔✔TRUE
|| || || || || || || || || || || || || ||
What should an auditor review for an operation? - ✔✔The operative note, codes selected,
|| || || || || || || || || || || || || ||
payer payment policy and NCCI edits prior to claim submission
|| || || || || || || || ||
