Page 1 of 213
CPMA PRACTICE EXAM - CERTIFIED
PROFESSIONAL MEDICAL AUDITOR EXAM |
{LATEST 2026/ 2027 UPDATE} COMPLETE
ACTUAL AND AUTHENTIC EXAM | BRAND NEW!
Dr. Black receives a demand letter from the OIG stating the sanctions
are sought under CMP for claims submitted by Dr. Black. He asks you,
his auditor, to review the letter and the claims that are under scrutiny.
It is determined that Dr. Black should not agree with the demand
letter. You recommend that Dr. Black:
A. Request a hearing before a federal court.
B. Request a hearing before an HHS administrative court judge.
C. Request a hearing with state board of appeals.
D. Request a hearing with the hospital's board of directors.
B. Request a hearing before an HHS administrative court judge.
A GI physician begins a diagnostic endoscopy. The physician identifies
some concerning lesions and makes the decision to perform an open
procedure the following week. Can both procedures be reported and
if so, what modifier should be appended?
A. No, only the open procedure can be reported
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B. Yes, report both procedures with modifier 59
C. Yes, report both procedures with modifier 58
D. Yes, report both procedures with modifier 51
C. Yes, report both procedures with modifier 58
An effective compliance plan attributes to which of the following:
A. Better informed employees
B. Reduced risk of criminal sanctions, or civil penalties
C. Effective operations and increased compliance with both federal
and state laws
D. All of the above
D. All of the above
A physician asks you, her auditor, what the specific difference is
between 1995 and 1997 versions of documentation guidelines. Your
response would be:
A. Risk of significant complications, morbidity and/or mortality
B. Past, Family and Social History
C. Exam elements
D. Medical Decision Making
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C. Exam elements
Which of the following code combinations is an example of
unbundling according to CPT®?
A. 25515, 20690
B. 11601, 12031
C. 92025, 65730
D. 49560, 49568
C. 92025, 65730
Which scenario best represents the correct use of modifier 26?
A. An ECG is performed in a physician's office and interpreted by the
physician. Modifier 26 is appended to the CPT® ECG code 93000.
B. Patient had an open inguinal hernia repair two weeks ago. He is in
the doctor's office because the surgical wound is bleeding. The
physician cleans the wound and applies wound adhesive to reclose a
small opening. Modifier 26 is appended to the E/M code.
C. A chest X-ray taken in the ED. The ED physician interprets the X-ray
and bills the CPT® radiology code with modifier 26. The ED physician is
not employed by the hospital.
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D. A patient with diabetic ketoacidosis has a blood test to check her
potassium level. After the initial potassium value is determined, a
subsequent blood test was ordered and performed on the same date.
Modifier 26 is appended to the subsequent blood test.
C. A chest X-ray taken in the ED. The ED physician interprets the X-ray
and bills the CPT® radiology code with modifier 26. The ED physician is
not employed by the hospital.
Which statement is TRUE regarding appending modifier 78 to a claim
for a service provided to a Medicare beneficiary?
A. When modifier 78 is appended, only the intraoperative percentage
is paid and no new global period begins.
B. When modifier 78 is appended, only the intraoperative percentage
is paid and a new global period begins.
C. When modifier 78 is appended, only the postoperative percentage
is paid and no new global period begins
D. When modifier 78 is appended, only the preoperative percentage is
paid and a new global period begins.
A. When modifier 78 is appended, only the intraoperative percentage
is paid and no new global period begins.
Which scenario supports medical necessity for critical care services?
CPMA PRACTICE EXAM - CERTIFIED
PROFESSIONAL MEDICAL AUDITOR EXAM |
{LATEST 2026/ 2027 UPDATE} COMPLETE
ACTUAL AND AUTHENTIC EXAM | BRAND NEW!
Dr. Black receives a demand letter from the OIG stating the sanctions
are sought under CMP for claims submitted by Dr. Black. He asks you,
his auditor, to review the letter and the claims that are under scrutiny.
It is determined that Dr. Black should not agree with the demand
letter. You recommend that Dr. Black:
A. Request a hearing before a federal court.
B. Request a hearing before an HHS administrative court judge.
C. Request a hearing with state board of appeals.
D. Request a hearing with the hospital's board of directors.
B. Request a hearing before an HHS administrative court judge.
A GI physician begins a diagnostic endoscopy. The physician identifies
some concerning lesions and makes the decision to perform an open
procedure the following week. Can both procedures be reported and
if so, what modifier should be appended?
A. No, only the open procedure can be reported
,Page 2 of 213
B. Yes, report both procedures with modifier 59
C. Yes, report both procedures with modifier 58
D. Yes, report both procedures with modifier 51
C. Yes, report both procedures with modifier 58
An effective compliance plan attributes to which of the following:
A. Better informed employees
B. Reduced risk of criminal sanctions, or civil penalties
C. Effective operations and increased compliance with both federal
and state laws
D. All of the above
D. All of the above
A physician asks you, her auditor, what the specific difference is
between 1995 and 1997 versions of documentation guidelines. Your
response would be:
A. Risk of significant complications, morbidity and/or mortality
B. Past, Family and Social History
C. Exam elements
D. Medical Decision Making
,Page 3 of 213
C. Exam elements
Which of the following code combinations is an example of
unbundling according to CPT®?
A. 25515, 20690
B. 11601, 12031
C. 92025, 65730
D. 49560, 49568
C. 92025, 65730
Which scenario best represents the correct use of modifier 26?
A. An ECG is performed in a physician's office and interpreted by the
physician. Modifier 26 is appended to the CPT® ECG code 93000.
B. Patient had an open inguinal hernia repair two weeks ago. He is in
the doctor's office because the surgical wound is bleeding. The
physician cleans the wound and applies wound adhesive to reclose a
small opening. Modifier 26 is appended to the E/M code.
C. A chest X-ray taken in the ED. The ED physician interprets the X-ray
and bills the CPT® radiology code with modifier 26. The ED physician is
not employed by the hospital.
, Page 4 of 213
D. A patient with diabetic ketoacidosis has a blood test to check her
potassium level. After the initial potassium value is determined, a
subsequent blood test was ordered and performed on the same date.
Modifier 26 is appended to the subsequent blood test.
C. A chest X-ray taken in the ED. The ED physician interprets the X-ray
and bills the CPT® radiology code with modifier 26. The ED physician is
not employed by the hospital.
Which statement is TRUE regarding appending modifier 78 to a claim
for a service provided to a Medicare beneficiary?
A. When modifier 78 is appended, only the intraoperative percentage
is paid and no new global period begins.
B. When modifier 78 is appended, only the intraoperative percentage
is paid and a new global period begins.
C. When modifier 78 is appended, only the postoperative percentage
is paid and no new global period begins
D. When modifier 78 is appended, only the preoperative percentage is
paid and a new global period begins.
A. When modifier 78 is appended, only the intraoperative percentage
is paid and no new global period begins.
Which scenario supports medical necessity for critical care services?
