CPMA Medical Auditor Practice Questions - AAPC Certified Professional Medical Auditor Exam - CPMA Medical Auditor Practice Questions - AAPC Certified Professional Medical Auditor Exam

Question 1

Case 001 (Random vs Targeted Sampling): During a provider audit workpaper review, the auditor must document a defensible finding. You must estimate an overall error rate across a broad provider population. Which sampling approach is strongest?

Select only the highest-dollar claims to maximize repayment findings. Use a statistically appropriate random sample aligned to the audit objective and defined population. Use convenience sampling from whichever records are easiest to retrieve. Pull only previously denied claims because they represent all coding risk.

Correct Answer:

Use a statistically appropriate random sample aligned to the audit objective and defined population.

Question 2

Case 002 (Statistical Extrapolation): In a compliance committee meeting, audit results are being translated into corrective action. Leadership asks whether sample findings can be projected across the full claim universe. What is required first?

Extrapolate any targeted sample as long as error severity seems high. Project findings only when at least one provider disputes the audit. Confirm statistically valid sampling methods and documented assumptions before extrapolating results. Avoid documenting assumptions because projections are inherently estimates.

Correct Answer:

Confirm statistically valid sampling methods and documented assumptions before extrapolating results.

Question 3

Case 003 (Audit Scope and Criteria): While validating sampled claims, the lead auditor is checking coding and documentation consistency. Before record review begins, what should the audit plan define most clearly?

Only projected financial impact, with scope determined after findings emerge. Only provider specialty, since objective details can be added at report time. Only payer contract terms, without coding/compliance criteria. Objective, scope boundaries, population, criteria, and documentation standards for review.

Correct Answer:

Objective, scope boundaries, population, criteria, and documentation standards for review.

Question 4

Case 004 (E/M MDM and Time Validation): At a revenue-cycle QA checkpoint, an auditor is preparing a formal report to leadership. An office E/M level appears overstated. What is the most defensible validation method?

Reconstruct level selection using documented MDM elements or qualifying total time per current guidance. Downgrade every visit with limited history regardless of MDM evidence. Use billed diagnosis count alone to validate E/M level. Accept provider-selected level when claim payment was successful.

Correct Answer:

Reconstruct level selection using documented MDM elements or qualifying total time per current guidance.

Question 5

Case 005 (Modifier 25 Audit Logic): During a payer overpayment response drill, the team is aligning audit evidence with policy timelines. A provider frequently reports modifier 25 with procedures. What evidence supports compliant use?

Any same-day E/M and procedure pairing regardless of note content. Documentation showing a significant, separately identifiable E/M service beyond procedure-related work. Automatic modifier use for all established-patient visits. A prior payer approval on unrelated claims.

Correct Answer:

Documentation showing a significant, separately identifiable E/M service beyond procedure-related work.

Question 1

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About this Exam

Prepare with the CPMA Medical Auditor Practice Questions - AAPC Certified Professional Medical Auditor Exam practice quiz. This question bank includes 100 questions covering audit, case, auditor, coding, and modifier. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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CPMA Medical Auditor Practice Questions - AAPC Certified Professional Medical Auditor Exam

This practice set contains 100 questions from the matching question bank and focuses on audit, case, auditor, coding, and modifier. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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CPMA Medical Auditor Practice Questions - AAPC Certified Professional Medical Auditor Exam

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