MEDICAL AUDITING FUNDAMENTALS: TEST QUESTIONS WITH
CORRECT ANSWERS.
1) Medical record Auditing entails conducting internal or external reviews of which
of these:
A) documentation
B) coding accuracy
C) policies
D) Procedures -- Answer ✔✔ documentation, coding accuracy, policies
and procedures ensure practitioners are compliant and meet all coding
and billing regulations of payer when submitting a claim
2) Who conducts an external audit? -- Answer ✔✔ Third-party payer
3) The levels of e/M service in CPT codebook recognize____ types of medical
decision making -- Answer ✔✔ 4
4) How many steps are there when auditing surgical medical records? -- Answer ✔✔
4
, 5) Which auditing tools are necessary when auditing surgical medical record --
Answer ✔✔ Audit tool, charge ticker coding books, NCCI edits, other pertinent
coding publications, detailed analysis and summary report
6) Regarding physical therapy interval of certified TX, a physician/NPP may certify a
plan of care for an interval length that's less than ____ days -- Answer ✔✔ 90
7) When reporting services for timed procedures for physical therapy, providers
should not bill for services performed for less than ____ minutes -- Answer ✔✔
8
8) According to the OIG, the acceptable standard for coding accuracy is (%) --
Answer ✔✔ 95%
9) What are the most important reasons to audit medical records? -- Answer ✔✔
to assess the completeness of the medical record
to determine accuracy of physicians documentation to discover lost revenue
10) What is auditing? -- Answer ✔✔ the process of examining the medical record,
verifying info, and gathering info to identify risk areas
11) What is a necessary audit tool for an auditor besides paper or electronic audit
tools? -- Answer ✔✔ Aggregate report
12) What audit gives an organization info about the quality of its medicals and helps
identify errors? -- Answer ✔✔ Baseline Audit
13) How often should an external audit be performed to ensure that internal audit
findings are objective? -- Answer ✔✔ annually
CORRECT ANSWERS.
1) Medical record Auditing entails conducting internal or external reviews of which
of these:
A) documentation
B) coding accuracy
C) policies
D) Procedures -- Answer ✔✔ documentation, coding accuracy, policies
and procedures ensure practitioners are compliant and meet all coding
and billing regulations of payer when submitting a claim
2) Who conducts an external audit? -- Answer ✔✔ Third-party payer
3) The levels of e/M service in CPT codebook recognize____ types of medical
decision making -- Answer ✔✔ 4
4) How many steps are there when auditing surgical medical records? -- Answer ✔✔
4
, 5) Which auditing tools are necessary when auditing surgical medical record --
Answer ✔✔ Audit tool, charge ticker coding books, NCCI edits, other pertinent
coding publications, detailed analysis and summary report
6) Regarding physical therapy interval of certified TX, a physician/NPP may certify a
plan of care for an interval length that's less than ____ days -- Answer ✔✔ 90
7) When reporting services for timed procedures for physical therapy, providers
should not bill for services performed for less than ____ minutes -- Answer ✔✔
8
8) According to the OIG, the acceptable standard for coding accuracy is (%) --
Answer ✔✔ 95%
9) What are the most important reasons to audit medical records? -- Answer ✔✔
to assess the completeness of the medical record
to determine accuracy of physicians documentation to discover lost revenue
10) What is auditing? -- Answer ✔✔ the process of examining the medical record,
verifying info, and gathering info to identify risk areas
11) What is a necessary audit tool for an auditor besides paper or electronic audit
tools? -- Answer ✔✔ Aggregate report
12) What audit gives an organization info about the quality of its medicals and helps
identify errors? -- Answer ✔✔ Baseline Audit
13) How often should an external audit be performed to ensure that internal audit
findings are objective? -- Answer ✔✔ annually
