LAB MANAGEMENT EXAM 5 QUESTIONS WITH
CORRECT ANSWERS
What is the primary federal health care program that may deny payment for a test that does
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n't meet its coverage criteria? - ans-Medicare
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What 7 fundamental elements does OIG suggest be included in a laboratory compliance pl
xz xz xz xz xz xz xz xz xz xz xz xz xz
an? - ans-written policies/standards of conduct, a compliance officer/
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committee, effective training, open lines of communication, disciplinary guidelines, auditin
xz xz xz xz xz xz xz xz xz
g, corrective action plan
xz xz xz
What is the general purpose of a compliance plan? - ans-
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to correct and prevent fraud and abuse and allow a lab to hold and maintain license and acc
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
reditation(billing for services that weren't provided) xz xz xz xz xz
What are CPT codes and what are their purpose? - ans-
xz xz xz xz xz xz xz xz xz xzxz
Current Procedural Terminology; describes service being ordered and provides standardiz
xz xz xz xz xz xz xz xz xz
ed monetary value
xz xz
Who oversees the day‐to‐day compliance activities of the lab? - ans-
xz xz xz xz xz xz xz xz xz xzxz
CCO (chief compliance officer) xz xz xz
How frequently should compliance training be conducted? - ans-
xz xz xz xz xz xz xz xzxz
upon employment, at least annually, and at regularly scheduled times
xz xz xz xz xz xz xz xz xz
Example of double billing - ans- xz xz xz xz xzxz
charging for tests that were calculated using underlying test results (LDL, indices,etc)
xz xz xz xz xz xz xz xz xz xz xz
What constitutes up coding? - ans- xz xz xz xz xzxz
the selection of a code to maximize reimbursement when such code is not the most appropr
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
iate descriptor of the service
xz xz xz xz
What forms of communication can be used to anonymously report suspected misconduct t
xz xz xz xz xz xz xz xz xz xz xz xz
o the compliance officer? - ans-ethics or compliance hotline
xz xz xz xz xzxz xz xz xz
What is the most common method OIG uses to monitor a lab's enforcement of compliance r
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
egulations? - ans-auditing and monitoring xz xzxz xz xz
If the lab discovers that a compliance violation has occurred, to whom should a full report be
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz x
sent? What is the acceptable time period for sending the report? - ans-
z xz xz xz xz xz xz xz xz xz xz xz xzxz
Send report to OIG within 60 days after the receipt of credible evidence of misconduct
xz xz xz xz xz xz xz xz xz xz xz xz xz xz
CORRECT ANSWERS
What is the primary federal health care program that may deny payment for a test that does
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
n't meet its coverage criteria? - ans-Medicare
xz xz xz xz xz xzxz
What 7 fundamental elements does OIG suggest be included in a laboratory compliance pl
xz xz xz xz xz xz xz xz xz xz xz xz xz
an? - ans-written policies/standards of conduct, a compliance officer/
xz xzxz xz xz xz xz xz xz
committee, effective training, open lines of communication, disciplinary guidelines, auditin
xz xz xz xz xz xz xz xz xz
g, corrective action plan
xz xz xz
What is the general purpose of a compliance plan? - ans-
xz xz xz xz xz xz xz xz xz xzxz
to correct and prevent fraud and abuse and allow a lab to hold and maintain license and acc
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
reditation(billing for services that weren't provided) xz xz xz xz xz
What are CPT codes and what are their purpose? - ans-
xz xz xz xz xz xz xz xz xz xzxz
Current Procedural Terminology; describes service being ordered and provides standardiz
xz xz xz xz xz xz xz xz xz
ed monetary value
xz xz
Who oversees the day‐to‐day compliance activities of the lab? - ans-
xz xz xz xz xz xz xz xz xz xzxz
CCO (chief compliance officer) xz xz xz
How frequently should compliance training be conducted? - ans-
xz xz xz xz xz xz xz xzxz
upon employment, at least annually, and at regularly scheduled times
xz xz xz xz xz xz xz xz xz
Example of double billing - ans- xz xz xz xz xzxz
charging for tests that were calculated using underlying test results (LDL, indices,etc)
xz xz xz xz xz xz xz xz xz xz xz
What constitutes up coding? - ans- xz xz xz xz xzxz
the selection of a code to maximize reimbursement when such code is not the most appropr
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
iate descriptor of the service
xz xz xz xz
What forms of communication can be used to anonymously report suspected misconduct t
xz xz xz xz xz xz xz xz xz xz xz xz
o the compliance officer? - ans-ethics or compliance hotline
xz xz xz xz xzxz xz xz xz
What is the most common method OIG uses to monitor a lab's enforcement of compliance r
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz
egulations? - ans-auditing and monitoring xz xzxz xz xz
If the lab discovers that a compliance violation has occurred, to whom should a full report be
xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz xz x
sent? What is the acceptable time period for sending the report? - ans-
z xz xz xz xz xz xz xz xz xz xz xz xzxz
Send report to OIG within 60 days after the receipt of credible evidence of misconduct
xz xz xz xz xz xz xz xz xz xz xz xz xz xz
