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Exam (elaborations)

CPCO CHAPTER 3 TEST QUESTIONS AND ANSWERS

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June 12, 2025
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Written in
2024/2025
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CPCO CHAPTER 3 TEST QUESTIONS AND ANSWERS




What should be readily accessible to all coding staff?
Billing certification
CPT™ codebook
All required coding resources
Nursing handbook - ANSWER All required coding resources
Coders require up-to-date resources in which to code correctly and file accurate
claims.

What can providers review that will introduce them to the compliance
requirements of a clinical lab?
Laboratory Provider Handbook
OIG's Clinical Lab Guidance
OIG Developing an Effective Compliance Program
Physician Desk Reference - ANSWER OIG's Clinical Lab Guidance
OIG Clinical Lab Guidance provides applicable information on compliance
performance and risk areas for laboratories.

Skilled Nursing Facilities (SNFs) are Medicare-certified institutions that
provide prolonged skilled nursing or rehabilitative care. Under which Medicare
part(s) is this care reimbursed?
A
B
C
Part A and Part B - ANSWER Part A and Part B
They SNFs are typically reimbursed under Part A for the cost of the majority of
items and services, including room, board, and ancillary items and services.
SNFs may also receive payment under Medicare Part B.

How many states now require nursing facilities to perform a background check
of state records for direct-access employees?
10

, 35
43
50 - ANSWER 43
Out of 50 states, 43 have mandated background check mandates on individuals
having direct contact with SNF patient and/or their personal items.

How many states mandate nursing homes perform a FBI checks on employees?
3
5
10
27

ANSWER 10
Out of 50 states, 10 states have mandated nursing homes perform an FBI
background checks on employees.

Which of the following would be a part of a billing company's written policies
and procedures?
Current Federal laws only
Current Federal and state laws
Current regional and Federal laws
Current state laws only - ANSWER Current Federal and state laws
With regards to claims, a billing company's written policies and procedures
have to reflect and complement current federal and state laws.

What third party plays an important part in accurate billing and reimbursement?
Billing agencies
Laboratories
Nursing homes
Office of Inspector General (OIG) - ANSWER Billing agencies
Providers have come to rely on billing agencies over the years to file clean
claims on their behalf.

What cannot be ignored and may warrant mandatory policy action to prevent
undue recurrence?

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