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CPMA practice exam A with complete solutions
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SOAP |! - |! Correct |! answer |! ✔Subjective, |! Objective, |! Assessment, |! Plan CHEDDAR |! - |! Correct |! answer |! ✔Chief |! complaint, |! Hx, |! Exam, |! Details |! of |! problem/complaint, |! Drugs |! & |! dosages, |! Assessment, |! Return |! visit Subjective |! - |! Correct |! answer |! ✔Pt |! complaint Objective |! - |! Correct |! answer |! ✔Provider |! observation Assessment |! - |! Correct |! answer |! ✔Medical |! Dx Plan |! - |! Correct |! answer |! ✔Treatment You |! are |! performing |! an |! audit |! of |! e/m |! services |! for |! a |! FP |! office. |! In |! the |! encounter |! you |! read |! the |! physician |! ordered |! and |! reviewed |! a |! differential |! WBC. |! What |! elements |! would |! you |! expect |! to |! see |! in |! the |! medical |! records? |! - |! Correct |! answer |! ✔Patient |! ID, |! assignment |! of |! benefits, |! pt's |! medical |! hx, |! immunizations, |! physical |! examination, |! lab |! report, |! clinical |! impression |! & |! physician |! orders. |! When |! labs |! are |! ordered, |! there |! must |! be |! a |! copy |! of |! the |! order |! and |! the |! lab |! report |! that |! the |! physician |! has |! reviewed.
What |! is |! the |! minimum |! requirement |! for |! the |! signature |! of |! the |! author |! of |! an |! entry |! in |! the |! medical |! records? |! - |! Correct |! answer |! ✔The |! first |! initial, |! last |! name |! and |! credentials Based |! on |! JCAHO |! accreditation |! guidance |! for |! personal |! data, |! what |! two |! elements |! must |! be |! evident |! in |! the |! medical |! records? |! - |! Correct |! answer |! ✔Personal |! biographical |! data |! and |! consent |! for |! Treatment |! or |! authorization |! for |! Treatment |! form. What |! is |! a |! comprehensive/focus |! review |! audit? |! - |! Correct |! answer |! ✔A |! large |! number |! of |! claims |! are |! selected |! for |! review |! that |! might |! be |! focused |! on |! specific |! procedure |! and/or |! dx |! codes What |! is |! RAT-STATS |! used |! for |! by |! an |! auditor? |! - |! Correct |! answer |! ✔Software |! used |! in |! performing |! statistical |! random |! samples |! and |! evaluating |! results. The |! Stark |! Statute |! applies |! to |! who |! and |! states |! what? |! - |! Correct |! answer |! ✔Applies |! to |! government |! payers. |! States |! the |! provider |! cannot |! refer |! pts |! to |! a |! health |! care |! facility |! where |! they |! or |! immediate |! family |! members |! has |! a |! financial |! relationship. What |! are |! the |! recommended |! number |! of |! charts |! to |! audit |! per |! provider |! and |! the |! minimum |! frequency |! of |! the |! audit? |! - |! Correct |! answer |! ✔ 10 |! records |! per |! provider |! each |! year.
What |! information |! should |! be |! reported |! to |! the |! OIG |! in |! the |! Claims |! Review |! findings, |! as |! part |! of |! an |! entity's |! Annual |! Report? |! - |! Correct |! answer |! ✔Claims |! review |! methodology, |! statistical |! sampling |! documentation, |! and |! claim |! review |! findings The |! penalties |! for |! violation |! of |! the |! Stark |! law |! include |! program |! exclusion |! for |! knowing |! violations |! and: |! - |! Correct |! answer |! ✔Potential |! $15,000CMP |! for |! each |! service An |! audit |! performed |! on |! one |! provider |! would |! be |! considered |! a: |! - |! Correct |! answer |! ✔A |! focused |! audit |! is |! one |! that |! looks |! at |! one |! item, |! one |! type |! of |! service, |! or |! one |! provider. ALJ |! - |! Correct |! answer |! ✔Administrative |! law |! judge OIG |! - |! Correct |! answer |! ✔Office |! of |! Inspector |! General CIA |! - |! Correct |! answer |! ✔Corporate |! Integrity |! Agreement IRO |! - |! Correct |! answer |! ✔Independent |! Review |! Organization HHS |! - |! Correct |! answer |! ✔Health |! and |! Human |! Services LEIE |! - |! Correct |! answer |! ✔List |! of |! Excluded |! Individuals |! /Entities
CMPL |! - |! Correct |! answer |! ✔Civil |! Monetary |! Penalties |! Law NIH |! - |! Correct |! answer |! ✔National |! Institute |! of |! Health