CPMA EXAM chapter 5 Questions And
Answers
What is numerical sampling? Sampling based on all possible services within a chosen
time frame. In this methodology, the sample size is based on all possible services within a certain
timeframe. This type of sample lends itself well to a random final selection.
What is considered good parameters for a baseline audit? Random audit of 10-15 records
per practitioner along with office and surgical procedures selected procedures selected randomly.
Which resource is valuable when performing a surgical audit? NCCI Manual assists the
auditor in determining bundling issues with CPT code services provided.
What is non-statistical sampling? Sample based on unique services that were defined in
the objective and scope and is used in focused audits. It may be considered judmental.
Which type of audit often realizes more objectivity than with an employed auditor
External audit- the advantage is the independence allows for a more objective review than
the one who is employed by the practice.
, CPMA EXAM chapter 5 Questions And
Answers
When performing a government audit, the NCCI edits manual can serve what purpose?
Support the use of modifiers and can point out bundling errors when performing the audit.
An audit performed prior to claims submission is referred to as what type of audit?
Prospective audit
As an auditor, you work for a CPA firm who has been asked to perform an audit of a new
practice to determine risk areas for their documentation. There have not been any prior audits at
this practice. What type of audit should be performed? Random audit
What is an example of how office policies are helpful in an audit? Office policies may
specify what to bill service and problem visit are provided at the same time.
Which list represents the most comprehensive list of items reviewed in a retrospective audit?
Medical record documentation, encounter form, explanation of benefits or remittance
advice, and payer policies.
A practice contacts an external auditor and explains the practice is billing incident-to services
and is not sure they are documenting appropriately, or following the guidelines. What services
Answers
What is numerical sampling? Sampling based on all possible services within a chosen
time frame. In this methodology, the sample size is based on all possible services within a certain
timeframe. This type of sample lends itself well to a random final selection.
What is considered good parameters for a baseline audit? Random audit of 10-15 records
per practitioner along with office and surgical procedures selected procedures selected randomly.
Which resource is valuable when performing a surgical audit? NCCI Manual assists the
auditor in determining bundling issues with CPT code services provided.
What is non-statistical sampling? Sample based on unique services that were defined in
the objective and scope and is used in focused audits. It may be considered judmental.
Which type of audit often realizes more objectivity than with an employed auditor
External audit- the advantage is the independence allows for a more objective review than
the one who is employed by the practice.
, CPMA EXAM chapter 5 Questions And
Answers
When performing a government audit, the NCCI edits manual can serve what purpose?
Support the use of modifiers and can point out bundling errors when performing the audit.
An audit performed prior to claims submission is referred to as what type of audit?
Prospective audit
As an auditor, you work for a CPA firm who has been asked to perform an audit of a new
practice to determine risk areas for their documentation. There have not been any prior audits at
this practice. What type of audit should be performed? Random audit
What is an example of how office policies are helpful in an audit? Office policies may
specify what to bill service and problem visit are provided at the same time.
Which list represents the most comprehensive list of items reviewed in a retrospective audit?
Medical record documentation, encounter form, explanation of benefits or remittance
advice, and payer policies.
A practice contacts an external auditor and explains the practice is billing incident-to services
and is not sure they are documenting appropriately, or following the guidelines. What services
