I am preparing to take the CPMA auditing exam in a couple weeks. In taking a number of practice tests, I'm finding that I have a few questions. Any thoughts anyone could share on any of these would be most appreciated.

1) In the ROM and the Exam, I think I'm seeing some variability regarding how findings are assigned to Neuro versus Psych. Things like Orientedx3 and other observations, seem sometimes to go into Neuro and sometimes into Psych. (I think I've actually seen Ox3 and memory specifically listed under Psych on a tool somewhere, but assignment seems to vary in practice.) If you have another item in Neuro or Psych already, where you put this item can affect whether you get to 10 for ROM or 8 for Exam. Is there any guidance on this?

2) For the Exam, it seems that the '95 guidelines almost always score higher than the '97 guidelines. Am I missing something?

3) I struggle some with getting the right level for Risk in MDM. I wish there were more examples on the risk table. Does anyone have any other examples they typically consider as being within particular levels for Risk? (e.g., MRI/CT, other things?) (I realize the risk table is the official tool from CMS and any additions would be unofficial.) I know we're supposed to use judgement, which will work better for me as I get more experience.

4) Regarding the Exam, other than for Comprehensive, it seems that Organ Systems and Body Areas are interchangeable. In fact, I just modified my tool to recognize the 12 Organ Systems and added the 4 remaining Body Systems: Neck, Chest, Head/Face and Genitalia/Groin/Buttocks. (I understand that Comprehensive considers only Body Systems.) Does this sound appropriate?

Any thoughts regarding any of these issues would be most appreciated. Sorry to be so long-winded. I'm learning so much by reading the discussion forum. Many thanks!

Greg Palmer