CPPM PRACTICE EXAM QUESTIONS
WITH ACTUAL SOLUTIONS 2025.
Which nnof nnthe nnfollowing nnscenarios nnis nnappropriate nnincident-to nnbilling? nn- nnANSWER:
nnD. nnA nnphysician's nnassistant nnat nnan nnOB/GYN nnpractice nnsees nnpatients nnfor nntheir nnfollow
nnup nnOB nnappointments nnwhile nnthe nnphysician nnsees nnnew nnOB nnpatients nnin nnthe nnoffice.
In nnthe nnpractice nnyou nnmanage, nnthe nnmedical nnassistants nnare nnresponsible nnfor nnpreparing
nnthe nnpatients nnfor nnthe nnphysician. nnThe nnmedical nnassistants nnplace nna nngreen nnfolder nnin
nnthe nndoor nnso nnthe nnphysician nnknows nnwhich nnpatient nnis nnnext nnto nnbe nnseen. nnThe
nnphysician nnrefuses nnto nnfollow nnthe nnsystem nnand nndetermines nnwho nnhe nnwill nnsee nnnext,
nnwhich nnis nnangering nnthe nnpatients nnbecause nnthey nnare nnwaiting nntoo nnlong nnin nnthe nnexam
nnroom. nnThe nnmedical nnassistant nnis nnextremely nnupset nnand nnclose nnto nntears. nnWhich nnof
nnthe nnfollowing nnresponses nnis nnan nnexample nnof nneffective nncommunication nnin nnthis
nnsituation? nn- nnANSWER: nnB. nn"I nnunderstand nnyour nnfrustration. nnSince nnthis nnsystem nndoes
nnnot nnappear nnto nnbe nnworking, nnwhat nndo nnyou nnsuggest?"
During nnthe nntypical nnpatient nnflow nnfor nnan nnencounter, nnwhen nnshould nnthe nncopayment nnbe
nncollected? nn- nnANSWER: nnA. nnWhen nnthe nnpatient nnchecks nnin nnwith nnthe nnfront nndesk nnprior
nnto nnthe nnappointment.
Which nnof nnthe nnfollowing nnis nnNOT nna nntypical nnduty nnof nna nnpractice nnmanager?
A. nnDeveloping nna nnstrategy nnto nnincrease nnpatient nnreferrals.
B. nnInventory nncontrol nnfor nnvaccines nnneeded nnfor nnschool nnphysicals.
C. nnProcessing nnprior nnauthorizations nnfor nnminor nnsurgeries nnperformed nnin nnthe nnoffice.
D. nnImplement nnstrategies nnto nnreduce nnthe nndays nnin nnA/R. nn- nnANSWER: nnC. nnProcessing
nnprior nnauthorizations nnfor nnminor nnsurgeries nnperformed nnin nnthe nnoffice.
Which nnstatement nnregarding nninsurance nnreform nnis nnTRUE?
A. nnA nnrequirement nnto nnpermit nnadult nnchildren nnto nnstay nnon nnfamily nnpolicies nnuntil nnage
nn26.B. nnRequire nnpre-authorizations nnfor nnonly nnemergency nndepartment nnservices.C.
nnLimit nnthe nnlifetime nnlimits nnon nnthe nndollar nnamount nnof nnthe nncoverage nnfor nnwhich nninsurers
nnwill nnpay.D. nnInsurers nnmust nnlimit nnany nnwaiting nnperiods nnfor nncoverage nnto nn30 nndays. nn-
nnANSWER: nnA. nnA nnrequirement nnto nnpermit nnadult nnchildren nnto nnstay nnon nnfamily nnpolicies
nnuntil nnage nn26.
A nnpatient nnis nnvery nnupset nnbecause nnher nninsurance nndenied nnher nnclaim. nnShe nnwas nnseen
nnfor nna nnroutine nnphysical nnwhich nnis nnnot nncovered nnby nnher nninsurance. nnThe nnpatient nnasks
nnyou nnto nnchange nnthe nndiagnosis nncode nnin nnorder nnfor nnthe nninsurance nncompany nnto nnpay
nnthe nnclaim. nnWhich nnof nnthe nnfollowing nnshould nnbe nndone?
, A. nnExplain nnto nnthe nnpatient nnthe nncodes nnare nncorrect nnand nnyou nncannot nnchange nnthe
nndiagnosis nnunless nnyou nnhave nnher nnconsent nnin nnwriting.
B. nnHave nnthe nnprovider nnor nncoder nnreview nnthe nnencounter nnto nnsee nnif nnanother nndiagnosis
nnis nnappropriate nnbefore nnmaking nnany nnchanges nnto nnthe nncodes.
C. nnChange nnthe nndiagnosis nnso nnthat nnthe nninsurance nncompany nnwill nnpay nnthe nnclaim
nnbecause nna nnservice nnwas nnrendered nnand nnshould nnbe nnpaid.
D. nnSubmit nnan nnappeal nnfor nnthe nninsurance nncompany nnto nnreconsider nnthe nnclaim nnand
nninclude nna nncopy nnof nnthe nnmedical nnrecord nnfor nnthe nndate nnof nnservice nnin nnquestion. nn-
nnANSWER: nnB. nnHave nnthe nnprovider nnor nncoder nnreview nnthe nnencounter nnto nnsee nnif
nnanother nndiagnosis nnis nnappropriate nnbefore nnmaking nnany nnchanges nnto nnthe nncodes.
Which nnof nnthe nnfollowing nnsites nnof nnservice nnmust nnadhere nnto nnEMTALA?
I. nnPhysician nnoffice
II. nnAmbulatory nnsurgical nncenter
III. nnEmergency nndepartment
IV. nnIntensive nncare nnunit nn- nnANSWER: nnIII nnis nncorrect
Under nnOSHA, nnan nnemergency nnaction nnplan nnshould nninclude:
I. nnEvacuation nnprocedures
II. nnFire nnextinguisher nnlocations
III. nnEmergency nncontacts nnand nncontact nninformation
IV. nnDesignated nnmeeting nnlocation
V. nnStaff nnassignments nnand nnresponsibilities nn- nnANSWER: nnThe nnemergency nnaction nnplan
nnshould nninclude:
• nnProcedures nnfor nnreporting nna nnfire nnor nnemergency
• nnEvacuation nnprocedures
• nnFire nnextinguisher nnlocations
• nnEmergency nncontacts nnand nncontact nninformation
• nnDesignated nnmeeting nnlocation
• nnStaff nnassignments nnand nnresponsibilities
To nnperform nnCLIA nnwaived nntests, nna nnpractice nnmust nnhave nna nn- nnANSWER: nnCertificate
nnof nnWaiver
A nnhospital nnprovides nnfree nnoffice nnspace nnto nnproviders nnwho nnadmit nnpatients nnfor
nninpatient nnprocedures. nnWhich nnlaw(s) nndoes nnthis nnviolate? nn- nnANSWER: nnB. nnAnti-
Kickback nnLaw
Which nnof nnthe nnfollowing nnis nnthe nnbest nnexample nnof nnquality nncare nnimprovement?
A. nnIncrease nninsurance nnclaim nnsubmission nnaccuracy nnto nndecrease nndenials.
B. nnFlexibility nnin nnthe nntraining nnschedule nnto nnaccommodate nnall nnemployees.
C. nnEffective nncommunication nnbetween nnstaff nnregarding nnsterilization nnof nnequipment.
D. nnMonitor nnthe nnno nnshow nnrate nnto nndetermine nnthe nncause nnand nnpossible nnsolution. nn-
nnANSWER: nnC. nnEffective nncommunication nnbetween nnstaff nnregarding nnsterilization nnof
nnequipment.
WITH ACTUAL SOLUTIONS 2025.
Which nnof nnthe nnfollowing nnscenarios nnis nnappropriate nnincident-to nnbilling? nn- nnANSWER:
nnD. nnA nnphysician's nnassistant nnat nnan nnOB/GYN nnpractice nnsees nnpatients nnfor nntheir nnfollow
nnup nnOB nnappointments nnwhile nnthe nnphysician nnsees nnnew nnOB nnpatients nnin nnthe nnoffice.
In nnthe nnpractice nnyou nnmanage, nnthe nnmedical nnassistants nnare nnresponsible nnfor nnpreparing
nnthe nnpatients nnfor nnthe nnphysician. nnThe nnmedical nnassistants nnplace nna nngreen nnfolder nnin
nnthe nndoor nnso nnthe nnphysician nnknows nnwhich nnpatient nnis nnnext nnto nnbe nnseen. nnThe
nnphysician nnrefuses nnto nnfollow nnthe nnsystem nnand nndetermines nnwho nnhe nnwill nnsee nnnext,
nnwhich nnis nnangering nnthe nnpatients nnbecause nnthey nnare nnwaiting nntoo nnlong nnin nnthe nnexam
nnroom. nnThe nnmedical nnassistant nnis nnextremely nnupset nnand nnclose nnto nntears. nnWhich nnof
nnthe nnfollowing nnresponses nnis nnan nnexample nnof nneffective nncommunication nnin nnthis
nnsituation? nn- nnANSWER: nnB. nn"I nnunderstand nnyour nnfrustration. nnSince nnthis nnsystem nndoes
nnnot nnappear nnto nnbe nnworking, nnwhat nndo nnyou nnsuggest?"
During nnthe nntypical nnpatient nnflow nnfor nnan nnencounter, nnwhen nnshould nnthe nncopayment nnbe
nncollected? nn- nnANSWER: nnA. nnWhen nnthe nnpatient nnchecks nnin nnwith nnthe nnfront nndesk nnprior
nnto nnthe nnappointment.
Which nnof nnthe nnfollowing nnis nnNOT nna nntypical nnduty nnof nna nnpractice nnmanager?
A. nnDeveloping nna nnstrategy nnto nnincrease nnpatient nnreferrals.
B. nnInventory nncontrol nnfor nnvaccines nnneeded nnfor nnschool nnphysicals.
C. nnProcessing nnprior nnauthorizations nnfor nnminor nnsurgeries nnperformed nnin nnthe nnoffice.
D. nnImplement nnstrategies nnto nnreduce nnthe nndays nnin nnA/R. nn- nnANSWER: nnC. nnProcessing
nnprior nnauthorizations nnfor nnminor nnsurgeries nnperformed nnin nnthe nnoffice.
Which nnstatement nnregarding nninsurance nnreform nnis nnTRUE?
A. nnA nnrequirement nnto nnpermit nnadult nnchildren nnto nnstay nnon nnfamily nnpolicies nnuntil nnage
nn26.B. nnRequire nnpre-authorizations nnfor nnonly nnemergency nndepartment nnservices.C.
nnLimit nnthe nnlifetime nnlimits nnon nnthe nndollar nnamount nnof nnthe nncoverage nnfor nnwhich nninsurers
nnwill nnpay.D. nnInsurers nnmust nnlimit nnany nnwaiting nnperiods nnfor nncoverage nnto nn30 nndays. nn-
nnANSWER: nnA. nnA nnrequirement nnto nnpermit nnadult nnchildren nnto nnstay nnon nnfamily nnpolicies
nnuntil nnage nn26.
A nnpatient nnis nnvery nnupset nnbecause nnher nninsurance nndenied nnher nnclaim. nnShe nnwas nnseen
nnfor nna nnroutine nnphysical nnwhich nnis nnnot nncovered nnby nnher nninsurance. nnThe nnpatient nnasks
nnyou nnto nnchange nnthe nndiagnosis nncode nnin nnorder nnfor nnthe nninsurance nncompany nnto nnpay
nnthe nnclaim. nnWhich nnof nnthe nnfollowing nnshould nnbe nndone?
, A. nnExplain nnto nnthe nnpatient nnthe nncodes nnare nncorrect nnand nnyou nncannot nnchange nnthe
nndiagnosis nnunless nnyou nnhave nnher nnconsent nnin nnwriting.
B. nnHave nnthe nnprovider nnor nncoder nnreview nnthe nnencounter nnto nnsee nnif nnanother nndiagnosis
nnis nnappropriate nnbefore nnmaking nnany nnchanges nnto nnthe nncodes.
C. nnChange nnthe nndiagnosis nnso nnthat nnthe nninsurance nncompany nnwill nnpay nnthe nnclaim
nnbecause nna nnservice nnwas nnrendered nnand nnshould nnbe nnpaid.
D. nnSubmit nnan nnappeal nnfor nnthe nninsurance nncompany nnto nnreconsider nnthe nnclaim nnand
nninclude nna nncopy nnof nnthe nnmedical nnrecord nnfor nnthe nndate nnof nnservice nnin nnquestion. nn-
nnANSWER: nnB. nnHave nnthe nnprovider nnor nncoder nnreview nnthe nnencounter nnto nnsee nnif
nnanother nndiagnosis nnis nnappropriate nnbefore nnmaking nnany nnchanges nnto nnthe nncodes.
Which nnof nnthe nnfollowing nnsites nnof nnservice nnmust nnadhere nnto nnEMTALA?
I. nnPhysician nnoffice
II. nnAmbulatory nnsurgical nncenter
III. nnEmergency nndepartment
IV. nnIntensive nncare nnunit nn- nnANSWER: nnIII nnis nncorrect
Under nnOSHA, nnan nnemergency nnaction nnplan nnshould nninclude:
I. nnEvacuation nnprocedures
II. nnFire nnextinguisher nnlocations
III. nnEmergency nncontacts nnand nncontact nninformation
IV. nnDesignated nnmeeting nnlocation
V. nnStaff nnassignments nnand nnresponsibilities nn- nnANSWER: nnThe nnemergency nnaction nnplan
nnshould nninclude:
• nnProcedures nnfor nnreporting nna nnfire nnor nnemergency
• nnEvacuation nnprocedures
• nnFire nnextinguisher nnlocations
• nnEmergency nncontacts nnand nncontact nninformation
• nnDesignated nnmeeting nnlocation
• nnStaff nnassignments nnand nnresponsibilities
To nnperform nnCLIA nnwaived nntests, nna nnpractice nnmust nnhave nna nn- nnANSWER: nnCertificate
nnof nnWaiver
A nnhospital nnprovides nnfree nnoffice nnspace nnto nnproviders nnwho nnadmit nnpatients nnfor
nninpatient nnprocedures. nnWhich nnlaw(s) nndoes nnthis nnviolate? nn- nnANSWER: nnB. nnAnti-
Kickback nnLaw
Which nnof nnthe nnfollowing nnis nnthe nnbest nnexample nnof nnquality nncare nnimprovement?
A. nnIncrease nninsurance nnclaim nnsubmission nnaccuracy nnto nndecrease nndenials.
B. nnFlexibility nnin nnthe nntraining nnschedule nnto nnaccommodate nnall nnemployees.
C. nnEffective nncommunication nnbetween nnstaff nnregarding nnsterilization nnof nnequipment.
D. nnMonitor nnthe nnno nnshow nnrate nnto nndetermine nnthe nncause nnand nnpossible nnsolution. nn-
nnANSWER: nnC. nnEffective nncommunication nnbetween nnstaff nnregarding nnsterilization nnof
nnequipment.
