CPPM Exam Prep with all Correct & 100% Verified
Answers |Latest Update |Already Graded A+
Revenue Per Visit (RPV) ✔Correct Answer-Total amount collected divides by the total number
of patient visits
Advance Benefit Notification (ABN) ✔Correct Answer-Notification given to patients advising
Medicare may not cover a certain procedure or service
Payment for fee for service is based on ✔Correct Answer-CPT & HCPCS Level II
MCO ✔Correct Answer-Private Health Plan
Place of Service (POS) determines correct reimbursement when ✔Correct Answer-The
professional component for services provided in a facility (I.e. HOD) are less than when provided
in a physician office as the physician doesn't have any practice expense at the facility. (In private
practice they pay rent, staff etc whereas is HOD these are paid by the facility)
DEA number ✔Correct Answer-Is not needed for the online application to CMS for an NPI
Customer service, optimizing physician time and claim quality assurance are key components to
which role? ✔Correct Answer-Front Desk
What can result in claim denial? ✔Correct Answer-Incorrect POS, incorrect NPI, and a
truncated diagnosis code
Patients are prepared to make payments at the time of there visits when? ✔Correct Answer-
Payment & collection policies are prominently posted in the office
What is the most important criteria to meet for the selection of Evaluation and Management
(E/M) codes? ✔Correct Answer-Medical necessity
What code set represents healthcare equipment, drugs and supplies? ✔Correct Answer-ICD-
10.PCS
ICD-10-CM ✔Correct Answer-International Classification of Diseases, Tenth Revision, Clinical
Modification CM codes represent the diagnosis/reason a service is performed.
ICD-10-PCS ✔Correct Answer-International Classification of Diseases, Revision Procedural
Coding System. These represent procedures performed at inpatient hospital facilities
, CPT codes ✔Correct Answer-current procedural terminology represent procedures performed
& bilked by physicians and non-physicians practitioners (APP's)
HCPCS Level II ✔Correct Answer-for products and supplies and services not included in level I.
the code is alphanumeric
Clean Claim Form ✔Correct Answer-A form that is complete and accurate and includes all
provider information and other additional information to process for payment
History of present illness ✔Correct Answer-Chronological description of the development of
patients complaint
Which codes are used by physicians and APP's to report professional services? ✔Correct
Answer-CPT & HCPCS Level Ii
Procedure codes are reported using which codes? ✔Correct Answer-CPT
Medicare patient with Parts A, B & C and no fault auto insurance is seen in the ED following a
minor auto accident, who is the primary insurance? ✔Correct Answer-Auto No-Fault
What is the first thing to review when a private payer repeatedly denies a specific code (o.e.
Venipuncture)? ✔Correct Answer-Payer Contract to see if denial is appropriate
Vital component of medical coding ✔Correct Answer-Codes based on complete and accurate
medical record documentation in the patients chart
How often should you run a productivity report? ✔Correct Answer-Twice a year, minimally
What is one purpose for a productivity report? ✔Correct Answer-To verify a good payer mix
for a strong revenue stream
What can add to an inefficient bad debt management process? ✔Correct Answer-Numerous
clinical & administrative approval requirements, unclear policies on write-off thresholds, and
unclear policies that limit the amount of balance billing
Capitation payment ✔Correct Answer-A prospective method of payment. Payments are based
on a physician fee schedules negotiated with the payer.
What accounts should be considered for collection? ✔Correct Answer-90+ days with a
balance greater than $10
What should you consider when conducting a registration audit? ✔Correct Answer-Address,
phone #, employer, insurance verification, and co-pay collected
Answers |Latest Update |Already Graded A+
Revenue Per Visit (RPV) ✔Correct Answer-Total amount collected divides by the total number
of patient visits
Advance Benefit Notification (ABN) ✔Correct Answer-Notification given to patients advising
Medicare may not cover a certain procedure or service
Payment for fee for service is based on ✔Correct Answer-CPT & HCPCS Level II
MCO ✔Correct Answer-Private Health Plan
Place of Service (POS) determines correct reimbursement when ✔Correct Answer-The
professional component for services provided in a facility (I.e. HOD) are less than when provided
in a physician office as the physician doesn't have any practice expense at the facility. (In private
practice they pay rent, staff etc whereas is HOD these are paid by the facility)
DEA number ✔Correct Answer-Is not needed for the online application to CMS for an NPI
Customer service, optimizing physician time and claim quality assurance are key components to
which role? ✔Correct Answer-Front Desk
What can result in claim denial? ✔Correct Answer-Incorrect POS, incorrect NPI, and a
truncated diagnosis code
Patients are prepared to make payments at the time of there visits when? ✔Correct Answer-
Payment & collection policies are prominently posted in the office
What is the most important criteria to meet for the selection of Evaluation and Management
(E/M) codes? ✔Correct Answer-Medical necessity
What code set represents healthcare equipment, drugs and supplies? ✔Correct Answer-ICD-
10.PCS
ICD-10-CM ✔Correct Answer-International Classification of Diseases, Tenth Revision, Clinical
Modification CM codes represent the diagnosis/reason a service is performed.
ICD-10-PCS ✔Correct Answer-International Classification of Diseases, Revision Procedural
Coding System. These represent procedures performed at inpatient hospital facilities
, CPT codes ✔Correct Answer-current procedural terminology represent procedures performed
& bilked by physicians and non-physicians practitioners (APP's)
HCPCS Level II ✔Correct Answer-for products and supplies and services not included in level I.
the code is alphanumeric
Clean Claim Form ✔Correct Answer-A form that is complete and accurate and includes all
provider information and other additional information to process for payment
History of present illness ✔Correct Answer-Chronological description of the development of
patients complaint
Which codes are used by physicians and APP's to report professional services? ✔Correct
Answer-CPT & HCPCS Level Ii
Procedure codes are reported using which codes? ✔Correct Answer-CPT
Medicare patient with Parts A, B & C and no fault auto insurance is seen in the ED following a
minor auto accident, who is the primary insurance? ✔Correct Answer-Auto No-Fault
What is the first thing to review when a private payer repeatedly denies a specific code (o.e.
Venipuncture)? ✔Correct Answer-Payer Contract to see if denial is appropriate
Vital component of medical coding ✔Correct Answer-Codes based on complete and accurate
medical record documentation in the patients chart
How often should you run a productivity report? ✔Correct Answer-Twice a year, minimally
What is one purpose for a productivity report? ✔Correct Answer-To verify a good payer mix
for a strong revenue stream
What can add to an inefficient bad debt management process? ✔Correct Answer-Numerous
clinical & administrative approval requirements, unclear policies on write-off thresholds, and
unclear policies that limit the amount of balance billing
Capitation payment ✔Correct Answer-A prospective method of payment. Payments are based
on a physician fee schedules negotiated with the payer.
What accounts should be considered for collection? ✔Correct Answer-90+ days with a
balance greater than $10
What should you consider when conducting a registration audit? ✔Correct Answer-Address,
phone #, employer, insurance verification, and co-pay collected
