CPPM Final Exam– Questions And Accurate Answers
You work for a primary care practice. A patient has recently suffered a
transient ischemic attack (TIA) and your physician wants to send the patient
to a specialist for a consultation. Which specialty would handle this type of
diagnosis?
a. Infectious disease
b. Endocrinology
c. Rheumatology
d. Neurology Right Ans - Neurology
A physician assistant (PA) is hired by a cardiology practice to help see patients
in the hospital. The PA performs all the rounds and notifies the physician on
call if there are any patients that need to be seen by a physician. Is it
appropriate to bill for the PA's services as incident-to?
a. No, incident-to services are not covered in a hospital setting.
b. Yes, as long as the physician sees the patient later in the day.
c. Yes, as long as the services are consistent with an established plan of care.
d. No, the physician needs to see every patient in order to bill incident to.
Right Ans - No, incident-to services are not covered in a hospital setting.
What is a good way to improve efficiency and accuracy in the registration
process?
a. Mail an invoice rather than collect at time of service.
b. Audit two records per staff member every year for accuracy.
c. Scan a copy of the patient's insurance card.
d. Email audit results to staff members with instructions to improve. Training
takes up too much time. Right Ans - Scan a copy of the patient's insurance
card.
What percentage of communication occurs through body language?
a. 35
b. 85
c. 55
d. 15 Right Ans - 55
Which of the following is the best example of communicating in a difficult
conversation?
a. Arguing or disagreeing with the speaker.
,b. Let the person know, "I understand how you feel."
c. Let the person know, "It's going to be alright."
d. Provide some advice for the person who is wrong. Right Ans - Let the
person know, "I understand how you feel."
Which option is NOT a reason to append a modifier to a CPT® or HCPCS Level
II code?
a. Separate and distinct service performed
b. Medical necessity
c. Discontinued procedure
d. Multiple procedures were performed Right Ans - Medical necessity
Which of the following is NOT a typical duty of a practice manager?
a. Implement strategies to reduce the A/R
b. Inventory control for supplies needed for minor surgeries
c. Fostering a referral source for new patients
d. Preparation of the patient for the physician Right Ans - Preparation of
the patient for the physician
Which of the following includes the payment amount and denial explanations
for claims submitted?
a. Denial reconciliation report
b. Accounts receivable report
c. Explanation of benefits (EOB)
d. Encounter form Right Ans - Explanation of benefits (EOB)
Which two code sets are used by physicians and non-physician practitioners
(NPPs) to report professional services for procedures in an outpatient setting?
I. CPT®
II. ICD-10-CM
III. ICD-10-PCS
IV. HCPCS Level II Right Ans - CPT®
HCPCS Level II
What does the abbreviation MBI stand for?
a. Medicare benefit identifier
b. Medicare billing indicator
c. Medicare beneficiary identifier
d. Medicare benefits indicator Right Ans - Medicare beneficiary identifier
, What type of reimbursement methodology is based on the average resources
required to care for an inpatient with a specific diagnosis?
a. FFS
b. MS-DRGs
c. APCs
d. NPI Right Ans - MS-DRGs
A common billing error is invalid or truncated ICD-10-CM codes. How can you
prevent this?
a. Always use the code selected by the provider.
b. Only use codes with seven characters.
c. Make sure the code on encounter form matches the code that is billed.
d. Update the practice management system when new, deleted, and revised
codes are released. Right Ans - Update the practice management system
when new, deleted, and revised codes are released.
Which option is a common reason for denials?
a. The provider is credentialed with multiple insurance carriers.
b. The patient's insurance was terminated following a service.
c. The patient did not show for a scheduled appointment.
d. The service is not medically necessary. Right Ans - The service is not
medically necessary.
Which of the following is a chronological description of the development of
the patient's complaints?
a. Medical decision making
b. History of present illness
c. Chief complaint
d. Medical necessity Right Ans - History of present illness
Common performance indicators for charge entry include:
I. Days to enter charges
II. Consent to treat
III. Missing charges
IV. Coding accuracy
V. Account balance collected
a. I, II, III, IV, and V
b. II, III, and IV
You work for a primary care practice. A patient has recently suffered a
transient ischemic attack (TIA) and your physician wants to send the patient
to a specialist for a consultation. Which specialty would handle this type of
diagnosis?
a. Infectious disease
b. Endocrinology
c. Rheumatology
d. Neurology Right Ans - Neurology
A physician assistant (PA) is hired by a cardiology practice to help see patients
in the hospital. The PA performs all the rounds and notifies the physician on
call if there are any patients that need to be seen by a physician. Is it
appropriate to bill for the PA's services as incident-to?
a. No, incident-to services are not covered in a hospital setting.
b. Yes, as long as the physician sees the patient later in the day.
c. Yes, as long as the services are consistent with an established plan of care.
d. No, the physician needs to see every patient in order to bill incident to.
Right Ans - No, incident-to services are not covered in a hospital setting.
What is a good way to improve efficiency and accuracy in the registration
process?
a. Mail an invoice rather than collect at time of service.
b. Audit two records per staff member every year for accuracy.
c. Scan a copy of the patient's insurance card.
d. Email audit results to staff members with instructions to improve. Training
takes up too much time. Right Ans - Scan a copy of the patient's insurance
card.
What percentage of communication occurs through body language?
a. 35
b. 85
c. 55
d. 15 Right Ans - 55
Which of the following is the best example of communicating in a difficult
conversation?
a. Arguing or disagreeing with the speaker.
,b. Let the person know, "I understand how you feel."
c. Let the person know, "It's going to be alright."
d. Provide some advice for the person who is wrong. Right Ans - Let the
person know, "I understand how you feel."
Which option is NOT a reason to append a modifier to a CPT® or HCPCS Level
II code?
a. Separate and distinct service performed
b. Medical necessity
c. Discontinued procedure
d. Multiple procedures were performed Right Ans - Medical necessity
Which of the following is NOT a typical duty of a practice manager?
a. Implement strategies to reduce the A/R
b. Inventory control for supplies needed for minor surgeries
c. Fostering a referral source for new patients
d. Preparation of the patient for the physician Right Ans - Preparation of
the patient for the physician
Which of the following includes the payment amount and denial explanations
for claims submitted?
a. Denial reconciliation report
b. Accounts receivable report
c. Explanation of benefits (EOB)
d. Encounter form Right Ans - Explanation of benefits (EOB)
Which two code sets are used by physicians and non-physician practitioners
(NPPs) to report professional services for procedures in an outpatient setting?
I. CPT®
II. ICD-10-CM
III. ICD-10-PCS
IV. HCPCS Level II Right Ans - CPT®
HCPCS Level II
What does the abbreviation MBI stand for?
a. Medicare benefit identifier
b. Medicare billing indicator
c. Medicare beneficiary identifier
d. Medicare benefits indicator Right Ans - Medicare beneficiary identifier
, What type of reimbursement methodology is based on the average resources
required to care for an inpatient with a specific diagnosis?
a. FFS
b. MS-DRGs
c. APCs
d. NPI Right Ans - MS-DRGs
A common billing error is invalid or truncated ICD-10-CM codes. How can you
prevent this?
a. Always use the code selected by the provider.
b. Only use codes with seven characters.
c. Make sure the code on encounter form matches the code that is billed.
d. Update the practice management system when new, deleted, and revised
codes are released. Right Ans - Update the practice management system
when new, deleted, and revised codes are released.
Which option is a common reason for denials?
a. The provider is credentialed with multiple insurance carriers.
b. The patient's insurance was terminated following a service.
c. The patient did not show for a scheduled appointment.
d. The service is not medically necessary. Right Ans - The service is not
medically necessary.
Which of the following is a chronological description of the development of
the patient's complaints?
a. Medical decision making
b. History of present illness
c. Chief complaint
d. Medical necessity Right Ans - History of present illness
Common performance indicators for charge entry include:
I. Days to enter charges
II. Consent to treat
III. Missing charges
IV. Coding accuracy
V. Account balance collected
a. I, II, III, IV, and V
b. II, III, and IV
