CPCA Cheat Sheet 2026

The 30 highest-yield CPCA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What does the term 'coordination of benefits' (COB) refer to in medical billing? → Determining which payer is primary when a patient has multiple coverages
2. Which of the following best describes a 'write-off' in medical billing? → The amount the provider agrees not to collect as part of a contractual agreement
3. Adjacent tissue transfer and rearrangement CPT codes (14000–14350) are selected based on: → The total area of the defect plus the flap design combined, and the anatomical location
4. When a physician uses a qualified surgical assistant during an aesthetic procedure, which modifier is typically appended to the assistant's claim? → -80
5. A dermatology practice submits a claim and receives a payment that is less than the billed amount with no explanation. What should the biller do first? → Request an Explanation of Benefits (EOB)
6. A cosmetic dermatology practice bills a procedure that is explicitly excluded from coverage. What is the best course of action? → Collect full payment directly from the patient before service
7. We are glad to ____ you the marketing director post after carefully examining your application. → Offer
8. Which of the following HCPCS codes correctly identifies the supply of incobotulinumtoxinA, 1 unit? → J0588
9. What is the standard global surgery period for major surgical procedures under Medicare guidelines? → 90 days
10. Valentino Garavani, an Italian fashion designer, announced his retirement in 2009 ______ 45 years in the industry. → After
11. Rectify the problems below: 18 - 3 + (- 5) = → 10
12. We anticipate a large increase in our monthly production capacity as a result of the _______ of our own factories in Vietnam. → Expand
13. Which modifier is appended to a CPT code to indicate that a procedure was performed bilaterally during the same operative session? → -50
14. When a payer bundles two separately billed services into one payment, what edit system is typically responsible? → NCCI (National Correct Coding Initiative) edits
15. Under HIPAA, what is the term for health information that can identify an individual? → Protected Health Information (PHI)
16. Which of the following situations would warrant the use of a code for an unstageable pressure ulcer (e.g., L89.150)? → The base of the ulcer is covered by slough and eschar, obscuring the full depth.
17. Which of the following best describes the primary function of the procerus muscle in facial expression? → Creates horizontal wrinkles at the root of the nose
18. What is the purpose of a HIPAA Risk Analysis? → To identify potential vulnerabilities and threats to ePHI
19. What is the maximum civil monetary penalty per violation category under HIPAA for willful neglect not corrected? → $1,900,000 per calendar year per violation category
20. What form is used to submit professional claims to Medicare and most commercial payers? → CMS-1500
21. A payer requires prior authorization for a laser skin resurfacing procedure. What happens if the provider performs the service without obtaining it? → The claim may be denied entirely
22. Which Medicare administrative document outlines covered services, billing requirements, and payment rules for specific specialties? → Local Coverage Determination (LCD)
23. Because of careful _______, the new equipment installation had no negative effects on the plant's operations. → Planning
24. Which term describes the maximum amount a payer will reimburse for a specific service based on fee schedule data? → Allowed amount
25. The HCPCS Level II code for abobotulinumtoxinA (Dysport) is J0586. What is the standard billing unit for this code? → 5 units
26. When no specific CPT code exists for a surgical procedure performed in an aesthetic practice, the coder should use: → An unlisted procedure code with supporting documentation
27. What is the global surgery period for minor surgical procedures, such as excision of a small skin lesion? → 10 days
28. How soon must a covered entity notify affected individuals after discovering a PHI breach? → Within 30 days
29. Peter rides the elevator up to the 10th floor starting from the ground floor. After that, Peter descends two stories and ascends eight. On what floor is Peter? → 16
30. What is the purpose of the National Provider Identifier (NPI) on a claim form? → To uniquely identify the healthcare provider billing for services