LATEST----CPCO Certification Exam
CERTIFIED PROFESSIONAL COMPLIANCE OFFICER (CPCO)
CERTIFICATION EXAM COVERAGE
CPCO certification exam offered by the AAPC. The coverage includes
HIPAA, the Stark Law, and the Anti-Kickback Statute, as well as fraud,
waste, and abuse prevention principles. It also assesses compliance
program development, auditing and monitoring techniques, risk
identification and management, and corrective action planning.
Additional areas include documentation requirements, coding
compliance, investigation procedures, and reporting mechanisms
within healthcare organizations.
,According to the Federal Sentencing Guidelines, "To have an effective
compliance and ethics program..., an organization shall exercise due
diligence to prevent and detect criminal conduct." The FSGs also state
organizations shall:
A. Promote an organizational culture that encourages ethical conduct
and a commitment to compliance with the law.
B. Implement mandatory compliance programs.
C. Perform annual audits to detect criminal conduct.
D. Immediately report evidence of misconduct to the authorities.
A. Promote an organizational culture that encourages ethical conduct
and a commitment to compliance with the law.
,If a physician practice uses another entity's standards of conduct, the
practice must:
A. Implement the standards of conduct as received because they have
already been approved.
B. Tailor those materials to the physician practice where they will be
applied.
C. Only select those standards that represent high risk issues for the
practice.
D. None of the above. Physician practices must create their own
standards of conduct. It would be a compliance violation to copy
another entity's standards of conduct.
B. Tailor those materials to the physician practice where they will be
applied.
, As the compliance contact for your physician practice, you are
charged with developing the policies and procedures related to
coding and billing. When developing these policies and procedures,
which of the following statements should be included?
A. If a new physician joins the practice and the new physician's NPI has
not been received, services performed should be reported using the
practice medical director's NPI.
B. For any services billed, documentation must be present in the
patient's medical record to support the services.
C. To avoid compliance risk, coding for E/M services should be based
solely on medical record documentation, even if it appears the level
of service is not warranted.
D. For denied services, billing staff should notify the physician to
change the reported diagnosis to allow for resubmission and payment
of the claim.
CERTIFIED PROFESSIONAL COMPLIANCE OFFICER (CPCO)
CERTIFICATION EXAM COVERAGE
CPCO certification exam offered by the AAPC. The coverage includes
HIPAA, the Stark Law, and the Anti-Kickback Statute, as well as fraud,
waste, and abuse prevention principles. It also assesses compliance
program development, auditing and monitoring techniques, risk
identification and management, and corrective action planning.
Additional areas include documentation requirements, coding
compliance, investigation procedures, and reporting mechanisms
within healthcare organizations.
,According to the Federal Sentencing Guidelines, "To have an effective
compliance and ethics program..., an organization shall exercise due
diligence to prevent and detect criminal conduct." The FSGs also state
organizations shall:
A. Promote an organizational culture that encourages ethical conduct
and a commitment to compliance with the law.
B. Implement mandatory compliance programs.
C. Perform annual audits to detect criminal conduct.
D. Immediately report evidence of misconduct to the authorities.
A. Promote an organizational culture that encourages ethical conduct
and a commitment to compliance with the law.
,If a physician practice uses another entity's standards of conduct, the
practice must:
A. Implement the standards of conduct as received because they have
already been approved.
B. Tailor those materials to the physician practice where they will be
applied.
C. Only select those standards that represent high risk issues for the
practice.
D. None of the above. Physician practices must create their own
standards of conduct. It would be a compliance violation to copy
another entity's standards of conduct.
B. Tailor those materials to the physician practice where they will be
applied.
, As the compliance contact for your physician practice, you are
charged with developing the policies and procedures related to
coding and billing. When developing these policies and procedures,
which of the following statements should be included?
A. If a new physician joins the practice and the new physician's NPI has
not been received, services performed should be reported using the
practice medical director's NPI.
B. For any services billed, documentation must be present in the
patient's medical record to support the services.
C. To avoid compliance risk, coding for E/M services should be based
solely on medical record documentation, even if it appears the level
of service is not warranted.
D. For denied services, billing staff should notify the physician to
change the reported diagnosis to allow for resubmission and payment
of the claim.
