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Medical Coding · CPMA

AAPC Certified Professional Medical Auditor (CPMA) Examination Practice Test

Medical auditing examines whether claims are supported by the health record and handled according to applicable coding and documentation rules. CPMA practice questions focus on audit planning, defining claim populations, evaluating medical necessity, measuring findings, and maintaining traceable records. These skills help auditors identify patterns, assess potential compliance concerns, and communicate findings clearly.

Exam overview

Exam providerAAPC
Exam codeCPMA
CategoryMedical Coding

About the AAPC Certified Professional Medical Auditor (CPMA) Examination Exam

Auditors must set review criteria before examining records, determine which claims fall within the audit scope, and select evidence that can substantiate each conclusion. A review may compare a reported service with the provider’s documentation, evaluate whether an order or medical-necessity rationale is present, and distinguish a documentation gap from a coding or billing error. When a possible overpayment appears, the auditor needs to validate the finding and its scope before supporting a repayment decision. Audit metrics, such as the frequency of a missing signature, help describe results across reviewed records; control evidence can show whether a practice’s stated review process actually occurred. Auditors also need organized, traceable records when responding to payer requests and must apply the code-set version relevant to the service date, including when codes change across calendar years.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

An auditor discovers that the same control failure may affect claims processed over several months. What is the most useful next step for estimating the scope of the issue?

  1. AReview only the claim that first revealed the failure
  2. BDefine the affected time period and population, then test a suitable set of records
  3. CAssume every claim in the practice is affected without testing
  4. DExclude claims processed before the discovery date
Show answerCorrect answer: B

To estimate scope, the auditor should define the potentially affected population and period, then use an appropriate review method. The results can inform whether broader remediation or further testing is needed.

Question 2

A reviewer is asked to assess whether a provider’s notes comply with a documentation policy. What should the auditor establish before beginning the review?

  1. AThe criteria and policy version applicable to the records under review
  2. BThe provider’s preferred note-writing style
  3. CThe number of corrections the provider made in the prior year
  4. DWhether the provider agrees with the audit conclusion in advance
Show answerCorrect answer: A

Audit conclusions should be measured against defined criteria that applied to the records at the relevant time. Confirming the applicable policy version promotes consistent and reproducible review.

Question 3

A compliance team plans an audit after noticing a sudden increase in claims for a particular service. What is the best way to define the audit population?

  1. AInclude all claims potentially affected by the increase, with clear dates, service criteria, and organizational scope
  2. BInclude only claims that have already been denied
  3. CInclude claims from whichever period produces the smallest sample
  4. DInclude unrelated services to make the review broader
Show answerCorrect answer: A

A clearly defined population establishes which claims the audit addresses and helps ensure consistent sampling and interpretation. The scope should be tied to the identified risk, time period, service, and relevant organizational units.

Question 4

A payer requests records for a defined set of claims. Which practice best supports a complete and traceable audit response?

  1. ASend only records that appear to support payment
  2. BMaintain a log of requested items, collected records, review status, and submission dates
  3. CReplace missing records with summaries written by billing staff
  4. DSubmit records without retaining copies or transmission details
Show answerCorrect answer: B

A tracking log helps ensure the response is complete, timely, and traceable. Records should not be selectively omitted or replaced by unsupported summaries.

Question 5

During an audit, the reviewer identifies a possible overpayment. What is the best initial step before making a repayment determination?

  1. AConfirm the finding against the record, applicable rules, and the organization’s established escalation process
  2. BOffset the amount against the next claim without notifying anyone
  3. CChange the claim diagnosis to match the payment
  4. DWait until the payer asks about the claim
Show answerCorrect answer: A

A potential overpayment should be validated and handled through the organization’s compliance and repayment processes. Applicable rules and timelines can vary, so the finding should be escalated promptly rather than ignored or informally offset.

Question 6

An auditor is reviewing a professional claim for an office visit and a separately reported diagnostic test. The test result is in the record, but no documentation explains why the test was medically necessary. What should the auditor assess?

  1. AWhether the test is supported by the patient's documented symptoms, findings, or clinical decision-making
  2. BWhether the test was performed by a staff member with the longest tenure
  3. CWhether the claim was submitted before the end of the month
  4. DWhether the patient has previously received the same test
Show answerCorrect answer: A

Medical necessity is assessed from the record and applicable coverage and coding requirements. The auditor should look for documentation connecting the test to the patient's condition or clinical evaluation; the other facts do not establish that connection.

Question 7

A clinic's internal audit finds a high rate of missing signatures on notes. Which audit metric would best describe how often this issue occurs in the reviewed records?

  1. AThe number of records reviewed
  2. BThe percentage of reviewed records with the signature deficiency
  3. CThe total charges for all claims in the clinic
  4. DThe number of clinicians employed by the clinic
Show answerCorrect answer: B

A deficiency rate uses the affected records as the numerator and the reviewed records as the denominator, expressed as a percentage. This directly communicates frequency within the reviewed set.

How to use this practice test

The free practice bank contains 50 published questions. Each session presents up to 20 random questions and shows results afterward. Use a session to test audit reasoning, then revisit missed items by identifying the review criterion, supporting record evidence, and decision that the scenario calls for.

Preparation tips

  • For each audit scenario, write down the review objective, applicable criteria, and claim population before deciding what evidence to examine.
  • Practice distinguishing documentation support, medical necessity, coding accuracy, and billing compliance; identify which issue the record actually raises.
  • For potential overpayments, map the steps from validating the finding to estimating affected claims and documenting the basis for any next action.
  • Calculate simple audit rates, such as the share of reviewed notes missing signatures, and state the numerator, denominator, and sample scope.
  • When a service crosses a code-set year boundary, match the applicable code version to the service date rather than the audit date.
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