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CPMA EXAM chapter 5 Questions And Answers
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CPMA EXAM chapter 5 Questions And Answers What is numerical sampling? Sampling based on all possible services within a chosen time frame. In this methodology, the sample size is based on all possible services within a certain timeframe. This type of sample lends itself well to a random final...

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  • October 19, 2024
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  • 2024/2025
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CPMA EXAM chapter 5 Questions And
Answers

What is numerical sampling? Sampling based on all possible services within a chosen

time frame. In this methodology, the sample size is based on all possible services within a certain

timeframe. This type of sample lends itself well to a random final selection.




What is considered good parameters for a baseline audit? Random audit of 10-15 records

per practitioner along with office and surgical procedures selected procedures selected randomly.




Which resource is valuable when performing a surgical audit? NCCI Manual assists the

auditor in determining bundling issues with CPT code services provided.




What is non-statistical sampling? Sample based on unique services that were defined in

the objective and scope and is used in focused audits. It may be considered judmental.




Which type of audit often realizes more objectivity than with an employed auditor

External audit- the advantage is the independence allows for a more objective review than

the one who is employed by the practice.

, CPMA EXAM chapter 5 Questions And
Answers
When performing a government audit, the NCCI edits manual can serve what purpose?

Support the use of modifiers and can point out bundling errors when performing the audit.




An audit performed prior to claims submission is referred to as what type of audit?

Prospective audit




As an auditor, you work for a CPA firm who has been asked to perform an audit of a new

practice to determine risk areas for their documentation. There have not been any prior audits at

this practice. What type of audit should be performed? Random audit




What is an example of how office policies are helpful in an audit? Office policies may

specify what to bill service and problem visit are provided at the same time.




Which list represents the most comprehensive list of items reviewed in a retrospective audit?

Medical record documentation, encounter form, explanation of benefits or remittance

advice, and payer policies.




A practice contacts an external auditor and explains the practice is billing incident-to services

and is not sure they are documenting appropriately, or following the guidelines. What services

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