AAPC CPMA Practice Exam Study
Questions And Answers
When must ABNs be signed? Far enough in advance that the beneficiary or representative
has time to consider the options and make an informed decision.
SOAP and CHEDDAR are two formats of medical record documentation. Which section of each
format would you find the patient's history? S in SOAP and H in CHEDDAR
Patients can request copies of disclosure of PHI under HIPAA: For a six (6) year period of
time
When can a RAC extrapolate the overpayment(s) on claims? If a RAC can demonstrate a
high level of error, the RAC can then extrapolate the findings and request a refund.
Example: Column 1 Code/Column 2 Code 45385/45380 CPT Code 45385 - Colonoscopy,
flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by
snare technique CPT Code 45380 - Colonoscopy, flexible, proximal to splenic flexure; with
biopsy, single or multiple Policy: More extensive procedure Modifier -59 is: Only
appropriate if the two procedures are performed on separate lesions or at separate patient
encounters.
, AAPC CPMA Practice Exam Study
Questions And Answers
Is reporting 14000 with 11401 unbundling? Yes according to CPT guidelines the excision
of a benign lesion or malignant lesion is not separately reportable.
Commercial and Government carriers audit medical records. Select the statement that is TRUE
regarding commercial and government carriers. Commercial carriers and Government
carriers both use claims data to identify providers and services to audit.
A comprehensive audit is: sometimes referred to as a focused review, is an audit of a
specified number of medical records in which a previous audit has identified problems based on
procedure and/or diagnosis codes or other audit findings.
What are the recommended number of charts to audit per provider and the minimum frequency
of the audit according to the OIG Recommended Compliance Plan? 10 records per
provider each year
True or False: When a CRNA and a Anesthesiologist both have a part in the procedure and
belong to the same practice they can both bill on the same claim TRUE
Questions And Answers
When must ABNs be signed? Far enough in advance that the beneficiary or representative
has time to consider the options and make an informed decision.
SOAP and CHEDDAR are two formats of medical record documentation. Which section of each
format would you find the patient's history? S in SOAP and H in CHEDDAR
Patients can request copies of disclosure of PHI under HIPAA: For a six (6) year period of
time
When can a RAC extrapolate the overpayment(s) on claims? If a RAC can demonstrate a
high level of error, the RAC can then extrapolate the findings and request a refund.
Example: Column 1 Code/Column 2 Code 45385/45380 CPT Code 45385 - Colonoscopy,
flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by
snare technique CPT Code 45380 - Colonoscopy, flexible, proximal to splenic flexure; with
biopsy, single or multiple Policy: More extensive procedure Modifier -59 is: Only
appropriate if the two procedures are performed on separate lesions or at separate patient
encounters.
, AAPC CPMA Practice Exam Study
Questions And Answers
Is reporting 14000 with 11401 unbundling? Yes according to CPT guidelines the excision
of a benign lesion or malignant lesion is not separately reportable.
Commercial and Government carriers audit medical records. Select the statement that is TRUE
regarding commercial and government carriers. Commercial carriers and Government
carriers both use claims data to identify providers and services to audit.
A comprehensive audit is: sometimes referred to as a focused review, is an audit of a
specified number of medical records in which a previous audit has identified problems based on
procedure and/or diagnosis codes or other audit findings.
What are the recommended number of charts to audit per provider and the minimum frequency
of the audit according to the OIG Recommended Compliance Plan? 10 records per
provider each year
True or False: When a CRNA and a Anesthesiologist both have a part in the procedure and
belong to the same practice they can both bill on the same claim TRUE
