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CPMA Chapter 1 Exam with Complete Solutions 2024/2025, Exams of Nursing
A practice exam for the certified professional medical auditor (cpma) certification, specifically covering chapter 1 content. The exam includes a series of questions and answers related to medicare abuse, documentation guidelines, the recovery audit contractor (rac) program, the false claims act (fca), the national correct coding initiative (ncci), the hhs oig work plan, the exclusion statute, and the role of an independent review organization (iro) under corporate integrity agreements (cia). The document could be useful for students preparing for the cpma exam, as it provides a comprehensive review of key topics and concepts covered in the first chapter. The level of detail and the focus on practical application of knowledge make this document a valuable resource for healthcare professionals seeking to enhance their understanding of medical coding, auditing, and compliance.
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CPMA chapter 1 Exam with complete
solutions 2024/
Which is considered Medicare abuse? - ANSWER-Misusing codes on a claim What is the most significant difference between 1996 and 1997 documentation guidelines? - ANSWER-Examination The goal of the Recovery Audit Contractor (RAC) program is to - ANSWER- Identify improper payments made on claims of healthcare services provided to Medicare beneficiaries Submitting claims for expired drugs falls under which of the following - ANSWER- False Claim Act (FCA) The False Claims Act (FCA) allows for mitigation under what circumstances? - ANSWER-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? - ANSWER-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? - ANSWER-HHS OIG Work Plan In the Exclusion Statue a physician is banned from? - ANSWER-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) - ANSWER-Acts as a third party medical review resource that provides objective, unbiased audits and reports