AAPC CPMA Practice Exam Study
Updated ACTUAL QUESTIONS AND
CORRECT ANSWERS
What elements must be in a medical record - CORRECT ANSWER Patient ID,
Assignment of Benefits, medical history, immunizations, physical exam, lab report, clinical
impression, physician orders
What is the minimum signature assignment of the author of entry in the medical record? -
CORRECT ANSWER First initial, Last Name and credentials
Based on the JC accreditation guidelines for personal data, what 2 elements must be evident
in the medical record? - CORRECT ANSWER There must be a patient information
sheet that contains biographical data, name, address, etc. along with authorization for
treatment whether it is an office visit, diagnostic services or surgical procedure.
What is the appropriate way to dispose of PHI that is no longer needed? - CORRECT
ANSWER Discard it in a locked shredding receptacle
When must ABNs be signed? - CORRECT ANSWER Far enough in advance that the
beneficiary or representative has time to consider the options and make an informed decision.
SOAP and CHEDDAR are two formats of medical record documentation. Which section of
each format would you find the patient's history? - CORRECT ANSWER S in SOAP
and H in CHEDDAR
Patients can request copies of disclosure of PHI under HIPAA: - CORRECT
ANSWER For a six (6) year period of time
When can a RAC extrapolate the overpayment(s) on claims? - CORRECT ANSWER If
a RAC can demonstrate a high level of error, the RAC can then extrapolate the findings and
request a refund.
, Example: Column 1 Code/Column 2 Code 45385/45380 CPT Code 45385 - Colonoscopy,
flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by
snare technique CPT Code 45380 - Colonoscopy, flexible, proximal to splenic flexure; with
biopsy, single or multiple Policy: More extensive procedure Modifier -59 is: - CORRECT
ANSWER Only appropriate if the two procedures are performed on separate lesions or
at separate patient encounters.
Is reporting 14000 with 11401 unbundling? - CORRECT ANSWER Yes according to
CPT guidelines the excision of a benign lesion or malignant lesion is not separately
reportable.
Commercial and Government carriers audit medical records. Select the statement that is
TRUE regarding commercial and government carriers. - CORRECT
ANSWER Commercial carriers and Government carriers both use claims data to
identify providers and services to audit.
A comprehensive audit is: - CORRECT ANSWER sometimes referred to as a focused
review, is an audit of a specified number of medical records in which a previous audit has
identified problems based on procedure and/or diagnosis codes or other audit findings.
What are the recommended number of charts to audit per provider and the minimum
frequency of the audit according to the OIG Recommended Compliance Plan? - CORRECT
ANSWER 10 records per provider each year
True or False: When a CRNA and a Anesthesiologist both have a part in the procedure and
belong to the same practice they can both bill on the same claim - CORRECT
ANSWER TRUE
What should an auditor review for an operation? - CORRECT ANSWER The operative
note, codes selected, payer payment policy and NCCI edits prior to claim submission
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
Updated ACTUAL QUESTIONS AND
CORRECT ANSWERS
What elements must be in a medical record - CORRECT ANSWER Patient ID,
Assignment of Benefits, medical history, immunizations, physical exam, lab report, clinical
impression, physician orders
What is the minimum signature assignment of the author of entry in the medical record? -
CORRECT ANSWER First initial, Last Name and credentials
Based on the JC accreditation guidelines for personal data, what 2 elements must be evident
in the medical record? - CORRECT ANSWER There must be a patient information
sheet that contains biographical data, name, address, etc. along with authorization for
treatment whether it is an office visit, diagnostic services or surgical procedure.
What is the appropriate way to dispose of PHI that is no longer needed? - CORRECT
ANSWER Discard it in a locked shredding receptacle
When must ABNs be signed? - CORRECT ANSWER Far enough in advance that the
beneficiary or representative has time to consider the options and make an informed decision.
SOAP and CHEDDAR are two formats of medical record documentation. Which section of
each format would you find the patient's history? - CORRECT ANSWER S in SOAP
and H in CHEDDAR
Patients can request copies of disclosure of PHI under HIPAA: - CORRECT
ANSWER For a six (6) year period of time
When can a RAC extrapolate the overpayment(s) on claims? - CORRECT ANSWER If
a RAC can demonstrate a high level of error, the RAC can then extrapolate the findings and
request a refund.
, Example: Column 1 Code/Column 2 Code 45385/45380 CPT Code 45385 - Colonoscopy,
flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by
snare technique CPT Code 45380 - Colonoscopy, flexible, proximal to splenic flexure; with
biopsy, single or multiple Policy: More extensive procedure Modifier -59 is: - CORRECT
ANSWER Only appropriate if the two procedures are performed on separate lesions or
at separate patient encounters.
Is reporting 14000 with 11401 unbundling? - CORRECT ANSWER Yes according to
CPT guidelines the excision of a benign lesion or malignant lesion is not separately
reportable.
Commercial and Government carriers audit medical records. Select the statement that is
TRUE regarding commercial and government carriers. - CORRECT
ANSWER Commercial carriers and Government carriers both use claims data to
identify providers and services to audit.
A comprehensive audit is: - CORRECT ANSWER sometimes referred to as a focused
review, is an audit of a specified number of medical records in which a previous audit has
identified problems based on procedure and/or diagnosis codes or other audit findings.
What are the recommended number of charts to audit per provider and the minimum
frequency of the audit according to the OIG Recommended Compliance Plan? - CORRECT
ANSWER 10 records per provider each year
True or False: When a CRNA and a Anesthesiologist both have a part in the procedure and
belong to the same practice they can both bill on the same claim - CORRECT
ANSWER TRUE
What should an auditor review for an operation? - CORRECT ANSWER The operative
note, codes selected, payer payment policy and NCCI edits prior to claim submission
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
