CMC Preparatory Course Outline

Key Course Objectives:

Medical Terminology

• Makeup and pronunciation of medical terms/words
• Key review of the human body systems, illustrations and review of anatomic position and directional terms
• Root words, prefixes, suffixes and supplemental terms
• Combined forms associated with medical conditions
• Definitions for common medical abbreviations
• Analysis of physician orders and narratives

ICD-9-CM Diagnostic Coding

• Instruction on the organization and groupings of ICD-9 for statistical purposes
• Accurate translation of medical terminology for diseases into codes
• Designation of symbols, punctuations and other conventions
• Outline of the complete coding and reimbursement equation
• Primary vs. secondary code selection
• Evaluate the dangers of using "cheat sheets"
• CMS diagnostic coding guidelines
• Differentiate between signs/symptoms and ill-defined conditions and a diagnosis
• Correct rules and guidelines for assigning codes for neoplasms, adverse effects, wounds, burns, injuries, HIV/AIDS, etc.
• Application of the coding conventions in correct coding
• How to determine the accurate diagnostic code order
• Proper use of the Drugs and Chemicals Table
• Proper use of supplementary classifications (V&E codes)
• Problem set exercises for hands-on comprehension

ICD-10 Coding Conversion

• This course includes ICD-10 preparation and implementation guidance. Further details on PMI's future ICD-10 training requirements are here
• Comparison of ICD-9 and ICD-10 code characteristics and rationale
• ICD-10 implementation overview of subcategories, classifications and extensions

HCPCS/CPT Procedural Coding

• A study of the uniform coding system that converts descriptions of medical, surgical and diagnostic services into numerical codes
• Understand the key elements of physician documentation that drives the assignment of CPT codes
• Identify ways to ensure accurate code assignment through the application of coding guidelines
• Learn the basic steps in the HCPCS/CPT coding process
• Identify and understand the basic format and conventions used in the HCPCS/CPT coding manual
• Know that all services in CPT are broken down into six categories, with specific guidelines for each group
• Differentiate between global and unbundled procedures, and explain their impact on coding in CPT
• Be able to identify unlisted procedures and how to bill them
• Proficiently use modifiers for appropriate reimbursement and efficient claims processing
• Understand the different types of evaluation and management service
• E&M errors can be costly to the practice, learn to apply the guidelines appropriately
• Reduce compliance audit exposure by studying the key concepts for determining levels of E&M service
• Improve medical record documentation and optimize reimbursement with the application of the E&M coding essentials
• Understand and apply the bundled services guidelines for surgery coding
• Differentiate between a new versus established patient
• Distinguish a consult from a referral*
• Know and apply surgery coding guidelines
• Exercises will provide hands-on experience in coding some common procedures and services provided by physicians

Ancillary Services & Advanced Coding

• Identify the different types of radiology services
• Distinguish between the application of technical and professional components
• Appropriately bill for supervision and interpretation (S&I) services
• Become familiar with different types of laboratory procedures
• Billing for qualitative detection versus quantitative detection
• Correctly billing laboratory panel tests
• Identify types of pathology services
• Billing for a clinical pathology consultation service versus an E&M consultation service*
• Understand how to code services in the medicine section
• Proper billing for administration of vaccines and immunizations
• Identify different types of dialysis
• Guidelines used to assign ophthalmologic examinations

* These items apply to carriers that do not currently follow Medicare's rules for consultations.

Course Prerequisite:
Candidates are strongly advised to have at least one year of medical coding experience in order to receive the most benefit from this class and exam.

This program includes classroom instruction, course manual, homework exercises, exam preparation handbook, and certification exam. Participants may take up to six hours to complete the CMC exam. A passing score of 70% or better will confer with CMC certification for one full year.

If you are seeking CEU credits for other certifications or organizations, please contact your organization for pre-approval and credit guidelines.

Required Class Materials:
Students must bring current editions of CPT, ICD-9- CM, HCPCS manuals and a medical dictionary to each class. For support while you learn, upgrade to the CD Kit for special price of $199 for live class participants.

Payment Plan Available:
PMI is helping its customers fit career training into their budget. Plan ahead and spread your payments out over time. Print PMI's Easy Pay Consent Form here, or call 800-259-5562 for more details.