Online Training Course

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.

 

CEUs

29

Length

1080 min

Price

$1250


The Certified Medical Coder is a leading certification for medical coding professionals that work with outpatient claims. The training program prepares candidates with advanced knowledge of the reimbursement cycle from patient encounter to claim. These skills are imperative for proper claim submission and accurate payment for services rendered.

For employers, auditors, and business associates, CMC signifies an ongoing commitment to continued professional development. Those who continue to expand their professional knowledge will have the edge in today's ever-changing healthcare climate.

Benefits of becoming/hiring a Certified Medical Coder:

·        protects the practice’s financial health by decreasing claim denials, and improving billing accuracy and compliance with current guidelines

·        does not rely on EHR presets, web searches or coding cheat sheets for coding assignments, which can cause repeat problems and trigger an audit

·        communicates with confidence with physicians, third-party payers, patients and business associates, which promotes advancement into chart auditing and supervisory roles

Recognition

For more than 35 years, PMI’s training has been recognized in health care systems, hospitals, medical societies, physician organizations, and learning institutions across the country. There are other coding certifications offered through organizations such as AHIMA and the AAPC. Some certifying bodies advertise their coding certification as the only recognized option, but the truth is that no government body recognizes or endorses a particular medical coding certification program over another. The training for each of these programs is very similar in terms of industry-standard guidelines and competency requirements for outpatient coders.

In 2004, the Centers for Medicare and Medicaid Services (CMS) named Practice Management Institute along with the American Health Information Management Association (AHIMA), and the American Academy of Professional Coders (AAPC) as organizations that provide advanced coding training for CMS-employed Provider Relations Research Specialists. This was in reference to the Medicare Modernization Act Provider Customer Service Program advanced training requirements needed to address complex provider questions pertaining to coverage, coding, and payment policies.1

The U.S. Department of Labor (DOL) lists the CMC in its online career training resource.2 Recognition by CMS, DOL, medical societies, learning institutions, and healthcare organizations across the country underlines the recognition of this certification as a leading provider of certification for medical office coding staff.

1. The Centers for Medicare and Medicaid Services transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R113OTN.pdf  CMS Manual System, Pub. 100-20, Transmittal 113, September 10, 2014. SUBJECT: Implementation of § 921 of the Medicare Modernization Act (MMA) – Provider Customer Service Program, page 8, bottom paragraph

2. U.S. Department of Labor, Employment and Training Administration recognition of the CMC: http://www.careerinfonet.org/certifications_new/default.aspx, type Certified Medical Coder in the "Find a Certification" box

Periodical References

Use certified medical coders to help navigate reimbursement regulation changes, PMI says, Kelly Gooch, Beckers Hospital CFO Report 2017 Aug 23

https://www.beckershospitalreview.com/finance/use-certified-medical-coders-to-help-navigate-reimbursement-regulation-changes-pmi-says.html

Easy tips for physicians to reduce billing errors, Keith Loria, Medical Economics, 2017 Aug 2

http://www.medicaleconomics.com/medical-economics/news/easy-tips-physicians-reduce-billing-errors

The Value of a Coding Education, John Rowe, MD, Blake Fagan, MD, David Mouw, MD, Dottie King and Kelly Christianson, Fam Pract Manag. 2005 Mar;12(3):20-22 http://www.aafp.org/fpm/20050300/20thev.html

Pam Joslin

MM, CMC, CMIS, CMOM, CMCO, CMCA-E/M, CEMA


Pam has more than 20 years of medical practice management, coding, reimbursement and compliance experience. She has managed in medical practices ranging from single to multi-specialty groups, including ASC. She is an advocate of process improvement and maximizing and empowering your employees to bring about the "best practice" results for your organization. She received her Master's in Management from University of Phoenix. She maintains memberships in professional organizations to support her continuing cycle of learning in the ever-changing healthcare industry. Prior to joining the PMI Instructor team she was an Adjunct Instructor and served on three advisory boards at a community college in San Antonio.

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.

Required Self-Supplied Materials

Students must have access to current editions of CPT®, HCPCS, ICD-10-CM, and a medical dictionary throughout the course and on the exam day. These coding reference materials are updated annually. The ICD-10-CM code set manual is valid through September 30 of the calendar year noted on the cover. The codes for the subsequent year go into effect on October 1 each year. CPT and HCPCS code sets are effective for the calendar year period beginning January 1 and ending December 31. PMI certification course students should utilize coding resources that are current at the time of their participation in the course and exam. Candidates that schedule an exam appointment for the next calendar year should bring coding books that are current on the date of their exam.   

Practice Management Institute (PMI) used current AMA published versions of the three coding manuals in the preparation of this course and exam.  While the usage of these materials does not in any way indicate the endorsement of a particular brand by Practice Management Institute, these resources are recommended to minimize potential discrepancies in coding information provided. Students should also be aware that the AMA publishes the only CPT® codebook with the official CPT guidelines. PMI does not sell medical coding books, but they are widely available for purchase or lease through a variety of nationwide publishers and retailers.

 

Exam

Earning CMC certification requires a passing score of 70 percent or better on the written exam. All exams are proctored live in testing centers across the country. Candidates have up to six hours to review questions and coding books and write in their answers based on the criteria given. Codes selected must designate the highest degree of specificity based on the documentation provided using current coding reference books. Exams are hand-graded and verified twice. In an age of digitized grading systems designed to simplify the grading process, PMI stands by its resolute exam standards as the most accurate measure of a CMC candidate’s coding ability. 

Certified Professional Standards of Excellence

Practice Management Institute certified professionals are required to uphold high professional standards, established by the Practice Management Institute Advisory Board for Certification Programming. Ethics requirements include adherence to legal guidelines according to governmental and third-party payer organizations and contracts.

Maintaining the CMC Certification

Medical office professionals, particularly those working in reimbursement roles, must stay current on updates and changes each year. Keeping the CMC certification active requires an ongoing commitment to continuing education. Twelve hours of continuing education are required each year to maintain active certification status. For information about renewing the CMC certification, visit the “Certification Renewal” section of our website.

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. The Live Class format includes a full course manual with workbook exercises, practice exam, and a six-hour proctored certification exam. Access to a medical terminology online course is also available.

Students will need self-supplied current editions of CPT®, HCPCS, ICD-10-CM, and a medical dictionary throughout the course and on the exam day. See the “Requirements” section for more information about these reference materials.

A score of 70% or better is required to earn the CMC certification. If the candidate does not achieve a passing grade on the first attempt, he/she may re-test for an additional fee.

Live Webinar

Participate in this course remotely via live webinar. Offered twice annually, this format includes a series of twelve 90-minute instructor-led webinar sessions*, a full course manual with workbook exercises, practice exam, and a six-hour proctored certification exam. Access to a medical terminology online course is also available.

Students will need self-supplied current editions of CPT®, HCPCS, ICD-10-CM, and a medical dictionary throughout the course and on the exam day. See the “Requirements” section for more information about these reference materials.

PMI’s Exam Coordinator schedules the exam in a testing center near the candidate’s location. A score of 70% or better is required to earn the CMC certification. If the candidate does not achieve a passing grade on the first attempt, he/she may re-test for an additional fee.

*Attendance at live sessions is optional; registered students can access the recordings online for up to six months after the original recording date.

Online Course

Start the Certified Medical Coder online course anytime*. This format includes access to twelve instructor-led 90-minute recorded sessions, a full course manual with workbook exercises, medical terminology course, a practice exam, and timed, six-hour proctored certification exam.

Students will need self-supplied current editions of CPT®, HCPCS, ICD-10-CM, and a medical dictionary throughout the course and on the exam day. See the “Requirements” section for more information about these reference materials.

PMI’s Exam Coordinator schedules the exam in a testing center near the candidate’s location. A score of 70% or better is required to earn the CMC certification. If the candidate does not achieve a passing grade on the first attempt, he/she may re-test for an additional fee.

*Registered students can access the recordings online for up to six months after the original recording date.

Exam Challenge

Experienced coding professionals can challenge the exam. A passing score of 70% or better is required to earn the CMC certification.

PMI’s Exam Coordinator schedules the exam in a testing center near the candidate’s location. If the candidate does not achieve a passing grade on the first attempt, he/she may re-test for an additional fee.

Candidates must have access to current editions of CPT®, HCPCS, ICD-10-CM, and a medical dictionary on the exam day. See “Requirements” section for more information about these reference materials and the CMC exam requirements. 

Exam Request Form

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