LAB MANAGEMENT EXAM 5
QUESTIONS AND ANSWERS
Whatwiswthewprimarywfederalwhealthwcarewprogramwthatwmaywdenywpaymentwforwawtest
wthatwdoesn'twmeetwitswcoveragewcriteria?w-wans-✔✔Medicare
Whatw7wfundamentalwelementswdoeswOIGwsuggestwbewincludedwinwawlaboratorywcomp
liancewplan?w-wans-✔✔writtenwpolicies/standardswofwconduct,wawcompliancewofficer/
committee,weffectivewtraining,wopenwlineswofwcommunication,wdisciplinarywguidelines,wa
uditing,wcorrectivewactionwplan
Whatwiswthewgeneralwpurposewofwawcompliancewplan?w-wans-
✔✔towcorrectwandwpreventwfraudwandwabusewandwallowwawlabwtowholdwandwmaintainwli
censewandwaccreditation(billingwforwserviceswthatwweren'twprovided)
WhatwarewCPTwcodeswandwwhatwarewtheirwpurpose?w-wans-
✔✔CurrentwProceduralwTerminology;wdescribeswservicewbeingworderedwandwprovidesw
standardizedwmonetarywvalue
Whowoverseeswthewday‐to‐daywcompliancewactivitieswofwthewlab?w-wans-
✔✔CCOw(chiefwcompliancewofficer)
Howwfrequentlywshouldwcompliancewtrainingwbewconducted?w-wans-
✔✔uponwemployment,watwleastwannually,wandwatwregularlywscheduledwtimes
Examplewofwdoublewbillingw-wans-
✔✔chargingwforwtestswthatwwerewcalculatedwusingwunderlyingwtestwresultsw(LDL,windic
es,etc)
Whatwconstituteswupwcoding?w-wans-
✔✔thewselectionwofwawcodewtowmaximizewreimbursementwwhenwsuchwcodewiswnotwthe
wmostwappropriatewdescriptorwofwthewservice
Whatwformswofwcommunicationwcanwbewusedwtowanonymouslywreportwsuspectedwmisc
onductwtowthewcompliancewofficer?w-wans-✔✔ethicsworwcompliancewhotline
WhatwiswthewmostwcommonwmethodwOIGwuseswtowmonitorwawlab'swenforcementwofwco
mpliancewregulations?w-wans-✔✔auditingwandwmonitoring
QUESTIONS AND ANSWERS
Whatwiswthewprimarywfederalwhealthwcarewprogramwthatwmaywdenywpaymentwforwawtest
wthatwdoesn'twmeetwitswcoveragewcriteria?w-wans-✔✔Medicare
Whatw7wfundamentalwelementswdoeswOIGwsuggestwbewincludedwinwawlaboratorywcomp
liancewplan?w-wans-✔✔writtenwpolicies/standardswofwconduct,wawcompliancewofficer/
committee,weffectivewtraining,wopenwlineswofwcommunication,wdisciplinarywguidelines,wa
uditing,wcorrectivewactionwplan
Whatwiswthewgeneralwpurposewofwawcompliancewplan?w-wans-
✔✔towcorrectwandwpreventwfraudwandwabusewandwallowwawlabwtowholdwandwmaintainwli
censewandwaccreditation(billingwforwserviceswthatwweren'twprovided)
WhatwarewCPTwcodeswandwwhatwarewtheirwpurpose?w-wans-
✔✔CurrentwProceduralwTerminology;wdescribeswservicewbeingworderedwandwprovidesw
standardizedwmonetarywvalue
Whowoverseeswthewday‐to‐daywcompliancewactivitieswofwthewlab?w-wans-
✔✔CCOw(chiefwcompliancewofficer)
Howwfrequentlywshouldwcompliancewtrainingwbewconducted?w-wans-
✔✔uponwemployment,watwleastwannually,wandwatwregularlywscheduledwtimes
Examplewofwdoublewbillingw-wans-
✔✔chargingwforwtestswthatwwerewcalculatedwusingwunderlyingwtestwresultsw(LDL,windic
es,etc)
Whatwconstituteswupwcoding?w-wans-
✔✔thewselectionwofwawcodewtowmaximizewreimbursementwwhenwsuchwcodewiswnotwthe
wmostwappropriatewdescriptorwofwthewservice
Whatwformswofwcommunicationwcanwbewusedwtowanonymouslywreportwsuspectedwmisc
onductwtowthewcompliancewofficer?w-wans-✔✔ethicsworwcompliancewhotline
WhatwiswthewmostwcommonwmethodwOIGwuseswtowmonitorwawlab'swenforcementwofwco
mpliancewregulations?w-wans-✔✔auditingwandwmonitoring
