CPMA Chapter 5 Review Question and
answers, 100% Accurate, rated A+
An audit performed after the claims have been submitted in referred to as what type of audit? - ✔✔-
Retrospective audit
What would be considered good parameters for a baseline audit? - ✔✔-Random audit of 10-15 records
per practitioner
What is/are the advantage of a peer review audit? - ✔✔-Provides feedback among providers
clinical decision-making can be addressed
coding accuracy
Which type of audit often realizes more objectivity than with an employed auditor? - ✔✔-External audit
How often should an internal audit be conducted minimally? - ✔✔-Annually
What tool might be helpful in defining which service to audit for a focused review - ✔✔-Utilization
reports
When performing a government audit, the NCCI edits manual can serve what purpose? - ✔✔-Support
the use of modifiers
What helpful information might be found on a local MAC's website regarding E/M services? - ✔✔-Local
MAC provide clarification of National policies such as the definition of what constitutes a detailed
history or exam versus an expanded problem focused
What type of error might be found by reviewing the encounter for and claim form? - ✔✔-Keying errors
occurring during the data entry process
answers, 100% Accurate, rated A+
An audit performed after the claims have been submitted in referred to as what type of audit? - ✔✔-
Retrospective audit
What would be considered good parameters for a baseline audit? - ✔✔-Random audit of 10-15 records
per practitioner
What is/are the advantage of a peer review audit? - ✔✔-Provides feedback among providers
clinical decision-making can be addressed
coding accuracy
Which type of audit often realizes more objectivity than with an employed auditor? - ✔✔-External audit
How often should an internal audit be conducted minimally? - ✔✔-Annually
What tool might be helpful in defining which service to audit for a focused review - ✔✔-Utilization
reports
When performing a government audit, the NCCI edits manual can serve what purpose? - ✔✔-Support
the use of modifiers
What helpful information might be found on a local MAC's website regarding E/M services? - ✔✔-Local
MAC provide clarification of National policies such as the definition of what constitutes a detailed
history or exam versus an expanded problem focused
What type of error might be found by reviewing the encounter for and claim form? - ✔✔-Keying errors
occurring during the data entry process
