Certified Medical Coder (CMC)®

The Certified Medical Coder (CMC)® is a training program and certification for experienced medical coders working with outpatient claims. The CMC certification is awarded to individuals who have passed the comprehensive written exam, demonstrating advanced competency in coding for outpatient medical claims.

Candidates for this program are encouraged to complete PMI’s free Medical Coding Assessment prior to enrollment. Questions? Call 800-259-5562.

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In today's complex practice environment, certified coders are in high demand. More physicians need a Certified Medical Coder (CMC)® capable of understanding the complexities of the reimbursement process.

Advanced coding skills limit audit liability showing auditors, compliance officers, employees and peers that you have taken steps to attain advanced knowledge and skills.

The CMC validates your achievement and demonstrates superior knowledge as an advanced coding professional. It helps you to communicate with improved confidence with physicians, third-party payers, patients and business associates. Your skills as a CMC will help decrease claim denials and improve your practice's financial health.

Certified Medical Coders are employed in thousands of medical practices across the country. The CMC certification is recognized by CMS and leading healthcare groups nationwide.

Top 3 Reasons to Attend

  • Communicate with improved confidence with physicians, third-party payers, patients and business associates.
  • Certification signifies advanced knowledge and skills to auditors, compliance officers, employers, and peers.
  • Certified Medical Coders are employed in thousands of medical practices across the country.

The Certified Medical Coder (CMC) is designed for experienced coders that have a minimum of one year of work experience as an outpatient medical coder. All candidates are encouraged to complete PMI’s free online Medical Coding Assessment to test their base knowledge and identify areas of deficiency where training may be beneficial in advance of the course. Candidates with less experience or wishing to brush up on their skills may consider completing the Principles of Coding before beginning the more intensive certification course.

Fundamental Training Recommendation

Inexperienced coders and those new to the field will benefit from fundamental training prior to attempting the Principles of Coding course referenced in the paragraph above. The Medical Coding Basics Bundle is a four-part series that covers the fundamentals of coding guidelines as well as an introduction to CPT, ICD-10-CM, and E/M coding.

The CMC online preparatory course consists of 29 hours of high-level coding instruction and practice exercises led by a PMI-approved Instructor.

Course Outline:

  • 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-10-CM Coding

  • Instruction on the guidelines, organization, and groupings of ICD-10-CM
  • Accurate translation of medical terminology for diseases into codes
  • Designation of symbols, punctuations, abbreviations, keywords, unspecified codes, and other coding conventions
  • ICD-10-CM subcategories, classifications, and extensions
  • Outline of the complete coding and reimbursement equation
  • Primary vs. secondary code selection
  • Diagnostic coding guidelines such as laterality, sequelae, etc.
  • Differentiate between signs/symptoms and ill-defined conditions and a diagnosis
  • Correct rules and guidelines for assigning codes for neoplasms, adverse effects, pregnancy, childbirth, wounds, burns, injuries, HIV/AIDS, etc.
  • Unsubstantiated and borderline diagnoses
  • Application of ICD-10 coding conventions
  • How to determine the accurate diagnostic code order
  • Proper use of tables
  • Problem set coding exercises for hands-on comprehension

Procedural Coding - CPT® and HCPCS

  • Key elements of physician documentation that drive the assignment of CPT codes
  • Accurate code assignment through the application of coding guidelines
  • HCPCS/CPT coding process and steps
  • Format and conventions used in the HCPCS/CPT coding manuals
  • Global and unbundled procedures, and their impact on coding in CPT
  • Identify unlisted procedures and how to bill them
  • Modifier usage for appropriate reimbursement and efficient claims processing
  • Evaluation and management service types
  • E/M guidelines and levels of service
  • Medical record documentation as related to the application of E/M coding
  • Bundled services guidelines for surgery coding
  • New versus established patient guidelines
  • Surgery coding guidelines
  • Hands-on exercises coding common procedures and services provided by physicians

Ancillary Services & Advanced Coding

  • Maternity and delivery services
  • Types of radiology services
  • Technical and professional component distinction
  • Billing supervision and interpretation (S&I) services
  • Laboratory procedure types
  • Billing for qualitative detection versus quantitative detection
  • Billing laboratory panel tests
  • Types of pathology services
  • Coding services in the medicine section
  • Billing for the administration of vaccines and immunizations
  • Types of dialysis
  • Guidelines used to assign ophthalmologic examinations
  • Advanced coding problem set exercises 

Live Class

Attend instructor-led classroom sessions, hosted in select hospitals, healthcare organizations, medical societies and colleges across the U.S.

Live Certified Medical Coder classroom format includes a full course manual with workbook exercises, medical terminology course access, a practice exam, and timed, six-hour proctored certification exam. A score of 70% or better is required to earn the CMC certification. If a passing grade is not achieved on the first attempt, candidates may re-test for an additional fee.

Live Webinar

Participate in the Certified Medical Coder course remotely with access to a series of twelve live 90-minute instructor-led webinar sessions (limited availability). Live session attendance is not required; registered webinar participants can access the recordings online anytime 24-48 hours after the original recording date.

This format also includes a full course manual with workbook exercises, medical terminology course access, a practice exam, and timed, six-hour proctored certification exam scheduled by PMI’s Exam Coordinator in a testing center near the candidate’s location. A score of 70% or better is required to earn the CMC certification. If a passing grade is not achieved on the first attempt, candidates may re-test for an additional fee.

Online Training

Start the Certified Medical Coder online training program anytime with access to twelve pre-recorded 90-minute instructor-led sessions.

The Certified Medical Coder on-demand format includes a full course manual with workbook exercises, medical terminology course access, a practice exam, and timed, six-hour proctored certification exam scheduled by PMI’s Exam Coordinator in a testing center near the candidate’s location. A score of 70% or better is required to earn the CMC certification. If a passing grade is not achieved on the first attempt, candidates may re-test for an additional fee.

Request Exam

All candidates for the CMC certification must pass a written exam, proctored live in testing centers across the country. Six hours are allowed to complete the exam; a passing score is 70 percent or better is required to earn the certification.

Candidates will review questions and write in their answers based on the criteria given. Codes selected must designate the highest degree of specificity. Written answers eliminate deselection of incorrect answers to arrive at the correct answer, which may allow a candidate to guess his/her way to a passing grade.

Exams are hand-graded and verified through a second grading process. In an age of digitized grading to simplify the grading process, PMI stands by this manual testing method as the most accurate measure of a candidate’s coding ability.

Hear what others have to say

As an employer, I strongly value education and support all my staff for continued learning and updating so we can all work as a team and speak the same language! I am so grateful to PMI for really changing my life professionally as well as personally I can work smarter not harder and have more free time with my family!

Linda D Parsi, MD, MBA, CPEDC, FAAP

 

As an instructor, I have taught and certified hundreds of new people over the past several years.  Those who entered the job market with a national certification were hired because of the validation that the certification gives.  Having a certified coder in the office who is on top of these changes helps to keep the office in compliance and the money coming into the office.  I like to look at the average days in AR for a provider’s claims.  If claims are not being paid it is often due to inaccurate coding. 

Libby Purser, CMC, CMIS, CMOM

Supervisor HIM

Dallas Diagnostic Association

 

PMI has played a key role in educating the medical office staff in Maryland over the last 9 years. I believe the type of education PMI provides has prepared our medical practices for the daily challenges in the ever-changing world of healthcare. Knowledge is power and PMI brings a wealth of resources to our physician offices throughout the Mid-Atlantic region.

Jama Allers, Practice Consultant

MedChi, The Maryland State Medical Society

 

In today’s healthcare environment there are many issues and mandates which are not being addressed by physician employer groups. Practices must invest in their staff’s educational knowledge. Physicians are compromised, from a medical, as well as a financial perspective, through their lack of understanding of the importance of maintaining an educated staff on healthcare issues. Most of the programs, webinars, and seminars by other organizations are lackluster and fail to bring a true return on the cost of these programs. Hence, I find some understanding of the hesitancy of physician practices to invest in those programs. PMI’s curriculum, however, is the exception. The variety of educational methods, whether in the classroom setting, webinars, or through Total Access, are not only very cost-effective but will provide the practice’s employees with the tools, educational resources and abilities to add value to their physician’s practice.

David Wilburn

Houston Eye Associates

 

Physicians must have confidence in the employees they hire and the information they receive from those employees, whether it be their managers, compliance officers, coding specialists, or insurance specialists. These are the people that enable them to keep a practice viable and profitable.  Having certified employees enables physicians to concentrate on their real responsibility---treating patients!

Barbara Good  CMCO, CMC, CMOM, CMIS

Physician Practice Advocate

West Virginia State Medical Association