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CPMA chapter 1, Questions and answers, 100% Accurate. Rated A+

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CPMA chapter 1, Questions and answers, 100% Accurate. Rated A+ Which is considered Medicare abuse? - -Misusing codes on a claim What is the most significant difference between 1996 and 1997 documentation guidelines? - -Examination The goal of the Recovery Audit Contractor (RAC) program i...

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  • February 16, 2023
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  • 2022/2023
  • Exam (elaborations)
  • Questions & answers
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CPMA chapter 1, Questions and
answers, 100% Accurate. Rated A+

Which is considered Medicare abuse? - ✔✔-Misusing codes on a claim



What is the most significant difference between 1996 and 1997 documentation guidelines? - ✔✔-
Examination



The goal of the Recovery Audit Contractor (RAC) program is to - ✔✔-Identify improper payments made
on claims of healthcare services provided to Medicare beneficiaries



Submitting claims for expired drugs falls under which of the following - ✔✔-False Claim Act (FCA)



The False Claims Act (FCA) allows for mitigation under what circumstances? - ✔✔-The person
committing the violation self-discloses and provides all known information within 30 days, fully
cooperates with the investigation, and there is no criminal prosecution, civil action, or administrative
action regarding the violation.



In the National Correct Coding Initiative, files contain a Correct Coding Modifier (CCM) indicator. What
does CCM indicator 1 mean? - ✔✔-A CCM is allowed and will bypass the edits



What document identifies the area that will be scrutinized by the federal government I. The current and
coming year? - ✔✔-HHS OIG Work Plan



In the Exclusion Statue a physician is banned from? - ✔✔-Participating in any federal or state healthcare
program by the OIG



What is the role of an independent review organization (IRO) under corporate integrity agreements
(CIA) - ✔✔-Acts as a third party medical review resource that provides objective, unbiased audits and
reports

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