CPMA Exam with Complete Solutions 2024

CPMA Exam with Complete Solutions 2024 B. If documentation supports the service, have the staff contact the carrier to reprocess the claims. Code 33010 was valid for the date of service billed. Rationale: The effective dates of codes are date of service driven. New CPT® codes become effective January 1st of every year. When auditing, verify codes based on the codes that were valid during the date of service.In February 2020, an auditor is asked to review 10 records for date of service 12/1/2019 to make sure the claims were paid correctly. Te claims included code 33010, which was denied on all the claims. Te denial was for an invalid code. What should the auditor advise the provider? A. Code 33010 was deleted efective 1/1/2020. Determine the correct new code and have staf resubmit claims. B. If documentation supports the service, have the staf contact the carrier to reprocess the claims. Code 55450 was valid for the date of service billed. C. Code 33010 was deleted efective 1/1/2020. Tis is a valid denial. Advise the staf to write of the balance. D. Code 33010 was efective for the date of service. Advise the staf to add modifer 59 and resubmit the claim. a. Review based solely on the submitted claims and regulatory guidelines. No medical records are needed. For an automated review, no medical records are needed. Improper payments are determined based solely on the submitted claims and regulatory guidelines such as National Coverage Determinations, Local Coverage Determinations, and the CMS Manuals.Recovery auditors may perform two types of reviews. What is an automated review? a. Review based solely on the submitted claims and regulatory guidelines. No medical records are needed. b. Review based on data and potential human review of a medical record or other documentation.