AAPC CPMA Certification Sample Questions

The AAPC Certified Professional Medical Auditor Certification Sample Question Set on this page is designed to familiarize you with the actual AAPC CPMA exam format and question types. These sample questions help you understand how questions are structured and what to expect on test day. While they provide a useful starting point, they represent only a limited preview of the real exam experience.

These sample questions are intended for evaluation and familiarization only. To understand exam style, pacing, and reasoning patterns more clearly, we recommend trying our online sample practice environment. If you are preparing for the AAPC Certified Professional Medical Auditor (CPMA) and want to assess your readiness more rigorously, structured, timed, scenario-based practice is recommended. This approach aligns with the cognitive demands and professional expectations typically associated with medical auditors, coding compliance professionals, revenue cycle audit professionals working in settings such as physician practices, healthcare organizations, payer and compliance audit environments.

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The demo introduces core concepts, while full-length premium simulations provide deeper, scenario-based coverage that more closely reflects the actual cognitive demands of the AAPC Certified Professional Medical Auditor exam, particularly in areas such as medical record auditing, documentation and compliance review, coding and reimbursement audit analysis. You can use these sample questions as a starting point, then progress to the AAPC CPMA Certification Practice Exam for stronger readiness. Our premium simulations are designed to mirror real exam conditions, helping you refine reasoning, pacing, and decision-making before your official exam attempt.

AAPC CPMA Sample Questions:

01. A claim reports a chest X-ray with two views. The radiology report documents “single frontal chest radiograph obtained; no acute cardiopulmonary abnormality.” The order requested two views, but the image log confirms only one image was captured.
What should the auditor conclude?
a) The billed two-view service is unsupported because the performed and documented study was a single-view chest X-ray
b) The two-view service is supported because the physician originally ordered two views
c) The two-view service is supported because the interpretation says there was no acute abnormality
d) The entire radiology service is unsupported because the ordered views and performed views differ

02. A compliance program performs audits and identifies overpayments, but it has no written policy describing how refunds are evaluated, approved, documented, or tracked. Different departments handle refunds inconsistently, and some overpayment files have no evidence of resolution.
Which compliance program improvement is most appropriate?
a) Allow each department to decide independently whether identified overpayments should be refunded
b) Establish a written overpayment investigation and refund tracking process with responsible owners and documentation requirements
c) Delay all refunds until a payer requests repayment because internal audit findings are preliminary
d) Stop documenting overpayment reviews because written tracking increases repayment exposure

03. A multispecialty group is building its annual audit plan. One service line has low claim volume but high reimbursement per claim, recent payer policy changes, and several provider questions about documentation. Another service line has high volume but no recent denials, no policy changes, and stable audit history.
Which approach best reflects risk-based audit planning?
a) Audit only services that already have confirmed payer overpayments
b) Audit only the highest-volume service line because volume is the only meaningful risk factor
c) Consider both financial impact and risk indicators rather than ranking topics by claim volume alone
d) Exclude low-volume services because they cannot create significant compliance exposure

04. A practice performs an internal audit of 40 randomly selected claims and finds five errors. The compliance officer wants to compare the result with last year’s audit, which used a targeted sample of 40 high-dollar claims selected by the billing manager. The officer asks whether the two error rates can be treated as directly comparable.
Which response is most appropriate?
a) The random sample should be discarded because targeted samples are required for internal audits
b) The rates are directly comparable because both audits reviewed exactly 40 claims
c) The targeted sample is more comparable because high-dollar claims are always representative
d) The rates should not be treated as directly comparable because the sampling methods and populations differ

05. A psychiatric provider bills interactive complexity with a psychotherapy service. The note documents routine psychotherapy for generalized anxiety disorder and states, “Patient was tearful during session.” There is no documentation of communication barriers, involvement of third parties, mandated reporting, use of play equipment, interpreter services, or other qualifying interactive complexity factors.
Which audit finding is most appropriate?
a) Interactive complexity is unsupported because tearfulness alone does not document a qualifying complexity factor
b) The psychotherapy service is unsupported because a tearful patient cannot participate in therapy
c) Interactive complexity is supported because emotional expression is always an interactive complexity element
d) Interactive complexity should replace psychotherapy because it is the higher-complexity service

06. An infusion center bills an initial therapeutic infusion and two additional hours. The medication administration record documents infusion start at 09:15 and stop at 11:05. The nurse’s note states that the patient remained under observation until 11:45 due to mild dizziness, but no medication was infusing after 11:05.
Which audit finding is most appropriate?
a) The entire infusion is unsupported because the patient experienced dizziness after the infusion
b) The additional infusion hours should be based on actual infusion time, not post-infusion observation time
c) Two additional hours are supported because the appointment lasted more than two hours total
d) Observation time should be added to infusion time because the patient remained in the infusion center

07. An operative report for laparoscopic cholecystectomy states that an intraoperative cholangiogram was “available if needed.” The body of the report documents gallbladder dissection and removal but does not describe cannulation of the cystic duct, contrast injection, fluoroscopic images, or interpretation of ductal anatomy. The claim includes a separate cholangiography service.
Which audit finding is most appropriate?
a) The cholangiography service is unsupported because the report does not document that it was performed
b) The cholangiography service is supported because the surgeon documented that it was available
c) Both services should be reported because all laparoscopic cholecystectomies include cholangiography
d) The cholecystectomy is unsupported because cholangiography was not performed during the case

08. An oncology infusion record documents premedication with an antiemetic IV push at 09:00, chemotherapy infusion from 09:15 to 10:45, and hydration from 10:45 to 11:30. The claim reports hydration as the initial service, chemotherapy as sequential, and antiemetic IV push as an unrelated injection. The record shows all services were administered through the same IV access during the chemotherapy encounter.
What should the auditor determine?
a) The antiemetic IV push must be unrelated because supportive medications are never part of chemotherapy encounters
b) All administrations should be coded as hydration because the same IV access was used throughout
c) Hydration must be initial because it was the last service completed during the encounter
d) The claim should be reviewed against infusion hierarchy because chemotherapy generally drives the initial service selection

09. An audit report states that a practice has a 35% coding error rate but does not separate overcoding, undercoding, documentation deficiencies, medical necessity failures, or modifier errors. Leadership asks how to prioritize corrective action.
Which report revision would best support decision-making?
a) Report only the highest-dollar claim because one example is enough to define the corrective action plan
b) Categorize findings by error type, frequency, financial impact, and root cause
c) Remove the error rate because percentages are never useful in compliance reporting
d) Combine all errors into a single category because detailed reporting may confuse leadership

10. A laboratory claim for thyroid testing is submitted with a diagnosis of obesity. The progress note documents fatigue, cold intolerance, hair thinning, and a family history of thyroid disease. The provider’s assessment states “rule out hypothyroidism.” The coder selected obesity because it was already on the problem list.
Which audit recommendation is most appropriate?
a) Keep obesity because problem-list diagnoses always provide stronger medical necessity support than symptoms
b) Code confirmed hypothyroidism because the provider ordered thyroid testing to rule it out
c) Remove all diagnoses because laboratory tests do not require diagnosis linkage
d) Select diagnosis support from the documented signs, symptoms, or suspected condition evaluation rather than defaulting to an unrelated problem-list diagnosis

Answers:

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Note: These sample questions are not official exam questions and are intended only for familiarization and study purposes. If you find any typos or data entry errors in these AAPC Certified Professional Medical Auditor (CPMA) sample questions, please let us know by emailing us at feedback@medicoexam.com