CPPM FINAL EXAM STUDY GUIDE WITH
COMPLETE SOLUTIONS
Which of the following is NOT a typical duty of a practice manager?
a. Implement strategies to reduce the A/R
b. Inventory control for supplies needed for minor surgeries
c. Fostering a referral source for new patients
d. Preparation of the patient for the physician - ANSWER-Preparation of the patient for
the physician
Which of the following includes the payment amount and denial explanations for claims
submitted?
a. Denial reconciliation report
b. Accounts receivable report
c. Explanation of benefits (EOB)
d. Encounter form - ANSWER-Explanation of benefits (EOB)
You work for a primary care practice. A patient has recently suffered a transient
ischemic attack (TIA) and your physician wants to send the patient to a specialist for a
consultation. Which specialty would handle this type of diagnosis?
a. Infectious disease
b. Endocrinology
c. Rheumatology
d. Neurology - ANSWER-Neurology
A physician assistant (PA) is hired by a cardiology practice to help see patients in the
hospital. The PA performs all the rounds and notifies the physician on call if there are
any patients that need to be seen by a physician. Is it appropriate to bill for the PA's
services as incident-to?
a. No, incident-to services are not covered in a hospital setting.
b. Yes, as long as the physician sees the patient later in the day.
c. Yes, as long as the services are consistent with an established plan of care.
d. No, the physician needs to see every patient in order to bill incident to. - ANSWER-
No, incident-to services are not covered in a hospital setting.
What is a good way to improve efficiency and accuracy in the registration process?
a. Mail an invoice rather than collect at time of service.
b. Audit two records per staff member every year for accuracy.
c. Scan a copy of the patient's insurance card.
d. Email audit results to staff members with instructions to improve. Training takes up
too much time. - ANSWER-Scan a copy of the patient's insurance card.
What percentage of communication occurs through body language?
,a. 35
b. 85
c. 55
d. 15 - ANSWER-55
Which of the following is the best example of communicating in a difficult conversation?
a. Arguing or disagreeing with the speaker.
b. Let the person know, "I understand how you feel."
c. Let the person know, "It's going to be alright."
d. Provide some advice for the person who is wrong. - ANSWER-Let the person know,
"I understand how you feel."
Which option is NOT a reason to append a modifier to a CPT® or HCPCS Level II
code?
a. Separate and distinct service performed
b. Medical necessity
c. Discontinued procedure
d. Multiple procedures were performed - ANSWER-Medical necessity
Which two code sets are used by physicians and non-physician practitioners (NPPs) to
report professional services for procedures in an outpatient setting?
I. CPT®
II. ICD-10-CM
III. ICD-10-PCS
IV. HCPCS Level II - ANSWER-CPT®
HCPCS Level II
What does the abbreviation MBI stand for?
a. Medicare benefit identifier
b. Medicare billing indicator
c. Medicare beneficiary identifier
d. Medicare benefits indicator - ANSWER-Medicare beneficiary identifier
What type of reimbursement methodology is based on the average resources required
to care for an inpatient with a specific diagnosis?
a. FFS
b. MS-DRGs
c. APCs
d. NPI - ANSWER-MS-DRGs
A common billing error is invalid or truncated ICD-10-CM codes. How can you prevent
this?
a. Always use the code selected by the provider.
b. Only use codes with seven characters.
c. Make sure the code on encounter form matches the code that is billed.
, d. Update the practice management system when new, deleted, and revised codes are
released. - ANSWER-Update the practice management system when new, deleted, and
revised codes are released.
Which option is a common reason for denials?
a. The provider is credentialed with multiple insurance carriers.
b. The patient's insurance was terminated following a service.
c. The patient did not show for a scheduled appointment.
d. The service is not medically necessary. - ANSWER-The service is not medically
necessary.
Which of the following is a chronological description of the development of the patient's
complaints?
a. Medical decision making
b. History of present illness
c. Chief complaint
d. Medical necessity - ANSWER-History of present illness
Common performance indicators for charge entry include:
I. Days to enter charges
II. Consent to treat
III. Missing charges
IV. Coding accuracy
V. Account balance collected
a. I, II, III, IV, and V
b. II, III, and IV
c. I, III, and IV
d. I, II, and IV - ANSWER-Days to enter charges
Missing charges
Coding accuracy
What is a benefit of an electronic remittance advice (ERA)?
a. Automated resubmission of claims with corrected information.
b. Claims are submitted electronically, therefore payment is received quickly.
c. Save staff time and reduce data entry errors.
d. An ERA will verify the contracted rate. - ANSWER-Save staff time and reduce data
entry errors. ??
A practice manager uses several reports to monitor the health of the practice. What
report is used to monitor the amount and type of services provided in the practice?
a. Productivity report
b. A/R aging report
c. Net collection rate report
d. Denial report - ANSWER-Productivity report
What should deposits on your bank statement be balanced against?
COMPLETE SOLUTIONS
Which of the following is NOT a typical duty of a practice manager?
a. Implement strategies to reduce the A/R
b. Inventory control for supplies needed for minor surgeries
c. Fostering a referral source for new patients
d. Preparation of the patient for the physician - ANSWER-Preparation of the patient for
the physician
Which of the following includes the payment amount and denial explanations for claims
submitted?
a. Denial reconciliation report
b. Accounts receivable report
c. Explanation of benefits (EOB)
d. Encounter form - ANSWER-Explanation of benefits (EOB)
You work for a primary care practice. A patient has recently suffered a transient
ischemic attack (TIA) and your physician wants to send the patient to a specialist for a
consultation. Which specialty would handle this type of diagnosis?
a. Infectious disease
b. Endocrinology
c. Rheumatology
d. Neurology - ANSWER-Neurology
A physician assistant (PA) is hired by a cardiology practice to help see patients in the
hospital. The PA performs all the rounds and notifies the physician on call if there are
any patients that need to be seen by a physician. Is it appropriate to bill for the PA's
services as incident-to?
a. No, incident-to services are not covered in a hospital setting.
b. Yes, as long as the physician sees the patient later in the day.
c. Yes, as long as the services are consistent with an established plan of care.
d. No, the physician needs to see every patient in order to bill incident to. - ANSWER-
No, incident-to services are not covered in a hospital setting.
What is a good way to improve efficiency and accuracy in the registration process?
a. Mail an invoice rather than collect at time of service.
b. Audit two records per staff member every year for accuracy.
c. Scan a copy of the patient's insurance card.
d. Email audit results to staff members with instructions to improve. Training takes up
too much time. - ANSWER-Scan a copy of the patient's insurance card.
What percentage of communication occurs through body language?
,a. 35
b. 85
c. 55
d. 15 - ANSWER-55
Which of the following is the best example of communicating in a difficult conversation?
a. Arguing or disagreeing with the speaker.
b. Let the person know, "I understand how you feel."
c. Let the person know, "It's going to be alright."
d. Provide some advice for the person who is wrong. - ANSWER-Let the person know,
"I understand how you feel."
Which option is NOT a reason to append a modifier to a CPT® or HCPCS Level II
code?
a. Separate and distinct service performed
b. Medical necessity
c. Discontinued procedure
d. Multiple procedures were performed - ANSWER-Medical necessity
Which two code sets are used by physicians and non-physician practitioners (NPPs) to
report professional services for procedures in an outpatient setting?
I. CPT®
II. ICD-10-CM
III. ICD-10-PCS
IV. HCPCS Level II - ANSWER-CPT®
HCPCS Level II
What does the abbreviation MBI stand for?
a. Medicare benefit identifier
b. Medicare billing indicator
c. Medicare beneficiary identifier
d. Medicare benefits indicator - ANSWER-Medicare beneficiary identifier
What type of reimbursement methodology is based on the average resources required
to care for an inpatient with a specific diagnosis?
a. FFS
b. MS-DRGs
c. APCs
d. NPI - ANSWER-MS-DRGs
A common billing error is invalid or truncated ICD-10-CM codes. How can you prevent
this?
a. Always use the code selected by the provider.
b. Only use codes with seven characters.
c. Make sure the code on encounter form matches the code that is billed.
, d. Update the practice management system when new, deleted, and revised codes are
released. - ANSWER-Update the practice management system when new, deleted, and
revised codes are released.
Which option is a common reason for denials?
a. The provider is credentialed with multiple insurance carriers.
b. The patient's insurance was terminated following a service.
c. The patient did not show for a scheduled appointment.
d. The service is not medically necessary. - ANSWER-The service is not medically
necessary.
Which of the following is a chronological description of the development of the patient's
complaints?
a. Medical decision making
b. History of present illness
c. Chief complaint
d. Medical necessity - ANSWER-History of present illness
Common performance indicators for charge entry include:
I. Days to enter charges
II. Consent to treat
III. Missing charges
IV. Coding accuracy
V. Account balance collected
a. I, II, III, IV, and V
b. II, III, and IV
c. I, III, and IV
d. I, II, and IV - ANSWER-Days to enter charges
Missing charges
Coding accuracy
What is a benefit of an electronic remittance advice (ERA)?
a. Automated resubmission of claims with corrected information.
b. Claims are submitted electronically, therefore payment is received quickly.
c. Save staff time and reduce data entry errors.
d. An ERA will verify the contracted rate. - ANSWER-Save staff time and reduce data
entry errors. ??
A practice manager uses several reports to monitor the health of the practice. What
report is used to monitor the amount and type of services provided in the practice?
a. Productivity report
b. A/R aging report
c. Net collection rate report
d. Denial report - ANSWER-Productivity report
What should deposits on your bank statement be balanced against?
