CPMA Practice Test B – Questions And Answers Evaluation and Management documentation is often captured in SOAP
format, which is the acronym for: Correct Ans - Subjective,
Objective, Assessment, Plan Failure to have which of the following forms in the medical record will result in payment sent to the beneficiary? Correct Ans - Assignment of benefits form Prior to undergoing a specific medical intervention, the law requires the provider to obtain an informed consent for treatment signed by the patient.In addition to the nature or purpose of the treatment and risks and benefits involved, the informed consent must include which of the following information? Correct Ans - Alternative treatment options and the risks and benefits of alternative treatment options
Outpatient physical therapy services cannot be initiated until: Correct
Ans - an initial plan of care has been established When auditing operative reports, the header describing the procedure Correct Ans - may not fully support the procedure documented in the body of the report.During an audit of a paper medical record, the auditor finds a correction was made using white-out and initialed by the
nurse. This method of correction is: Correct Ans - unacceptable
because the original content is not readable.An auditor identifies claims for services provided by a non-physician provider as Incident-to during the month the physician
was on vacation. This would be considered: Correct Ans - Fraud
The penalties for violation of the Stark law include program exclusion for
knowing violations and: Correct Ans - potential $15,000 CMP
(prior to inflation) for each service You audit a provider who performs and bills for an arthroscopic rotator cuff repair, 29827, and for an arthroscopic debridement, 29822. The payer 1 / 2
contract specifies NCCI edit rules will be applied. There is an NCCI edit against reporting both procedures during the same operative session; in reviewing the surgeon's documentation, you find that the debridement was performed in a different site supporting the 59 modifier, which is allowed under NCCI. This is an example of: Correct Ans - Proper Coding and Billing Practice The False Claims Act allows for reduction of penalties to two times the amount of damages (as opposed to three times) under what condition? Correct Ans - The person fully cooperates with the investigation of the violation The compliance program guidance (CPG) document identifies four risk areas most likely to affect a physician's practice. The risk areas include: Correct Ans - Coding and billing, reasonable and necessary services, documentation, improper inducements.The manager of a small physician's practice who is also the compliance officer, contacts you an auditor, stating that a coding and billing violation has been identified by the billing department manager. You advise the compliance officer to
document which of the following in the practice's compliance file:
Correct Ans - date of incident, name of reporting party, name of person responsible for taking action, followup action taken According to CPT coding guidelines for inpatient consultation services, which statement is correct? Correct Ans - Only one consultation is reported by the consultant per hospital admission Minor procedures as defined by Medicare have a zero or 10-day postoperative period. Which statement is TRUE regarding minor and endoscopic procedures? Correct Ans - There is no preoperative period and an office visit is billable if a significant and separately identifiable service is performed in addition to the procedure.
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