And Answers
When must ABNs be signed? Far enough in advance that the beneficiary or representative
has time to consider the options and make an informed choice
What is the appropriate way to dispose of PHI that is no longer needed? Discard it in a
locked shredding receptacle
Which of the following would NOT be expected to fall under the responsibility or oversight of
an organization's compliance committee? C. Recommending a specific merit increase in
pay for employee's adherence to the code of conduct
A family physician requests a post payment audit on claims from a particular commercial payer
from which he is receiving denials. Whenever the provider performs a minor procedure with an
E/M service, the minor surgery is reimbursed but the E/M service is denied. You review 10
charts and all cases are documented and coded correctly. What could be the reason for the
denial? The payer contract may bundle the E/M service when performed on the same day
as the minor surgery
, AAPC CASES CPMA Review Questions
And Answers
Which type of case is not prosecuted under the federal false claims act? A. Physician tax
issues
What are the recommended number of charts to audit per provider and the minimum frequency
of the audit? C. 10 records per provider each year
How is RAT-STATS used by an auditor? B. Software used in performing statistical
random samples and evaluating results
A comprehensive audit is: A. A large number of claims are selected for a review that
might be focused on specific procedure and/or diagnosis codes.
According to the 2017 _________, the OIG will review Medicare Part B payments for prolonged
services to determine whether the payments were made according to Medicare requirements.
B. OIG Work Plan
Commercial and Government carriers audit medical records. Select the statement that is true
regarding commercial and government carriers. B. Commercial carriers and Government
carriers both use claims data to find locate providers and services to audit.