CPCO EXAM 2025 QUESTIONS AND
ANSWERS
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of
1996 (HIPAA), what is the name of the national program designed to coordinate Federal,
State and local law enforcement activities with respect to health care fraud and abuse? -
....ANSWER ...-Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective compliance and
ethics program..., an organization shall exercise due diligence to prevent and detect
criminal conduct." The FSGs also state organizations shall: - ....ANSWER ...-
Promote an organizational culture that encourages ethical conduct and a commitment to
compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must: -
....ANSWER ...-Tailor those materials to the physician practice where they will be
applied.
Question 4
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1
, As the compliance contact for your physician practice, you are charged with developing
the policies and procedures related to coding and billing. When developing these
policies and procedures, which of the following statements should be included? -
....ANSWER ...-For any services billed, documentation must be present in the
patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician assistants
and nurse practitioners. There have been several questions by the physicians on how
incident to services should be billed. The compliance officer has called the Medicare
Administrative Contractor for the practice and was given some information on how
incident to services should be billed. Because the practice will be relying on the
information received from the Medicare Administrative Contractor, what steps should
the compliance officer take at the conclusion of the call according to the OIG
Compliance Guidance for Individual and Small Group Physician Practices? -
....ANSWER ...-Document the conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and
procedures should: - ....ANSWER ...-Be sure any time frames or requirements
listed can be accomplished given the practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy statement:
Centennial Medical Associates is committed to following Federal, State, and Local laws,
rules, guidelines, and regulations. To promote this effort, Centennial Medical Associates
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 2
ANSWERS
Question 1
Under Public Law 104-191, the Health Insurance Portability and Accountability Act of
1996 (HIPAA), what is the name of the national program designed to coordinate Federal,
State and local law enforcement activities with respect to health care fraud and abuse? -
....ANSWER ...-Health Care Fraud and Abuse Control Program (HCFAC)
Question 2
According to the Federal Sentencing Guidelines, "To have an effective compliance and
ethics program..., an organization shall exercise due diligence to prevent and detect
criminal conduct." The FSGs also state organizations shall: - ....ANSWER ...-
Promote an organizational culture that encourages ethical conduct and a commitment to
compliance with the law.
Question 3
If a physician practice uses another entity's standards of conduct, the practice must: -
....ANSWER ...-Tailor those materials to the physician practice where they will be
applied.
Question 4
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1
, As the compliance contact for your physician practice, you are charged with developing
the policies and procedures related to coding and billing. When developing these
policies and procedures, which of the following statements should be included? -
....ANSWER ...-For any services billed, documentation must be present in the
patient's medical record to support the services.
Question 5
City Orthopedics, a large physician group practice employs several physician assistants
and nurse practitioners. There have been several questions by the physicians on how
incident to services should be billed. The compliance officer has called the Medicare
Administrative Contractor for the practice and was given some information on how
incident to services should be billed. Because the practice will be relying on the
information received from the Medicare Administrative Contractor, what steps should
the compliance officer take at the conclusion of the call according to the OIG
Compliance Guidance for Individual and Small Group Physician Practices? -
....ANSWER ...-Document the conversation and retain the records.
Question 6
Developing effective compliance policies and procedures is an important part of any
compliance program. To help your practice mitigate compliance risk, policies and
procedures should: - ....ANSWER ...-Be sure any time frames or requirements
listed can be accomplished given the practice's resources.
Question 7
Select the best phrase from the list below to complete the following policy statement:
Centennial Medical Associates is committed to following Federal, State, and Local laws,
rules, guidelines, and regulations. To promote this effort, Centennial Medical Associates
…FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 2
