CPMA Study Guide Exam Questions And
Answers
What is considered essential elements to allow for proper coding of an operative report?
*the approach
*type of anesthesia
*location & severity of the wounds repaired.
Who is NOT considered a covered entity under HIPAA? Health care consultant
What entails the proper authentication of an entry in a medical record? Legible signature
of the author and the date the entry is signed.
What is the time limit mandated by CMS for adding a late entry into a medical record?
There is not a time limit.
When should an ABN be signed? Prior to performing a procedure that may be denied for
lack of medical necessity to a Medicare beneficiary
, CPMA Study Guide Exam Questions And
Answers
Under a Corporate Integrity Agreement how many charts must be audited to determine the
financial error rate? 50 charts.
When using LCD and CMS Program Guidance for a resource for an audit, what should the
auditor keep in mind? Local carriers follow LCDs, LMRPs, and CMS Guidance Programs
but QICs, ALJs, and MACs are not bound by them.
When reporting claim review findings under a Corporate Integretity Agreement, and Independent
Review organization must provide? A detailed report with an analysis & a narrative
explanation with findings & supporting rationale regarding the claim review including the results
of the discovery or full sample.
Accurate statement about NCCI? You need to check individual carriers to see if they have
their own bundling edits or follow NCCI guidelines.
A provider asks you to perform an audit of claims that have been denied payment with XYZ
insurance. Since contracting with XYZ all E/M codes filed with EKG interpretation have been
Answers
What is considered essential elements to allow for proper coding of an operative report?
*the approach
*type of anesthesia
*location & severity of the wounds repaired.
Who is NOT considered a covered entity under HIPAA? Health care consultant
What entails the proper authentication of an entry in a medical record? Legible signature
of the author and the date the entry is signed.
What is the time limit mandated by CMS for adding a late entry into a medical record?
There is not a time limit.
When should an ABN be signed? Prior to performing a procedure that may be denied for
lack of medical necessity to a Medicare beneficiary
, CPMA Study Guide Exam Questions And
Answers
Under a Corporate Integrity Agreement how many charts must be audited to determine the
financial error rate? 50 charts.
When using LCD and CMS Program Guidance for a resource for an audit, what should the
auditor keep in mind? Local carriers follow LCDs, LMRPs, and CMS Guidance Programs
but QICs, ALJs, and MACs are not bound by them.
When reporting claim review findings under a Corporate Integretity Agreement, and Independent
Review organization must provide? A detailed report with an analysis & a narrative
explanation with findings & supporting rationale regarding the claim review including the results
of the discovery or full sample.
Accurate statement about NCCI? You need to check individual carriers to see if they have
their own bundling edits or follow NCCI guidelines.
A provider asks you to perform an audit of claims that have been denied payment with XYZ
insurance. Since contracting with XYZ all E/M codes filed with EKG interpretation have been
