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AAPC CASES CPMA Review Verified Guide

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AAPC CASES CPMA Review Verified Guide As an auditor, what would you expect to see in the medical record for an evaluation and management service? A) Patient identification, assignment of benefits, patient's medical history, immunizations, physical examination, lab report, clinical impressio...

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  • July 11, 2024
  • 6
  • 2023/2024
  • Exam (elaborations)
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AAPC CASES CPMA Review Verified Guide
As an auditor, what would you expect to see in the medical record for an evaluation and management
service?



A) Patient identification, assignment of benefits, patient's medical history, immunizations, physical
examination, lab report, clinical impression, and physician orders.

B) Patient identification, assignment of benefits, patient's medical history, immunizations, physical
examination, lab report.

C) Patient identification, assignment of benefits, patient's medical history, immunizations, physical
examination.

D) Patient identification, assignment of benefits.



Correct answer: A) Patient identification, assignment of benefits, patient's medical history,
immunizations, physical examination, lab report, clinical impression, and physician orders.



Who would not be expected to submit operative notes as an auditor?



A) Surgical assistants

B) Nurses

C) Physicians

D) Medical assistants



Correct answer: A) Surgical assistants



What is an example of fraudulent behavior by a provider who knows that an evaluation and
management service they provide on the same date as a major procedure will be bundled so they
submit the claim for the E/M with a different date of service?



A) Fraud

B) Abuse

C) Neglect

, D) Error



Correct answer: A) Fraud



In preparation for a high volume of patients coming in for chemotherapy, a nurse documents the
chemotherapy treatments in advance. Would this cause concern in an audit?



A) No

B) Yes

C) Maybe

D) It depends



Correct answer: B) Yes



Patients can request copies of disclosure of PHI under HIPAA for how many years?



A) 3 years

B) 5 years

C) 6 years

D) 10 years



Correct answer: C) 6 years



Which section of each format would you find the patient's history in SOAP and CHEDDAR?



A) S in SOAP and C in CHEDDAR

B) C in SOAP and S in CHEDDAR

C) S in both SOAP and CHEDDAR

D) C in both SOAP and CHEDDAR

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