CERTIFICATION FEE

$1,250

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Course Description

Certified Medical Coder (CMC)® validates advanced training and knowledge as an outpatient coding professional. Earning certification helps protect the practice from risk and boosts the reimbursement cycle by improving the provider/billing communication link, resulting in more accurate claim submissions.

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.

PMI CMC course is recognized by the Centers for Medicare and Medicaid Services (CMS) as an example coding certification source for its Intermediary Provider Customer Service Program. This recognition by CMS and hundreds of other healthcare organizations reinforces PMI’s position as a leading provider of certification for medical office staff.

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 administration of vaccines and immunizations
  • Types of dialysis
  • Guidelines used to assign ophthalmologic examinations

Earning Your Certification with Practice Management Institute:

Those who continue to expand their professional knowledge will have the edge in today’s ever-changing health care climate. Each Certification curriculum and exam has passed a thorough review process, ensuring that the materials are current and accurate, and testing standards are strictly enforced. PMI’s National Advisory Board and Faculty Team have real-world experience in all aspects of running a successful medical practice.

  • Certification is a currency that validates a person’s commitment to the profession.
  • Certification provides a sense of personal achievement and employer confidence.
  • Certification helps to protect the practice’s compliance efforts.
  • Physicians need educated staff with expert knowledge in handling the administrative side of their business.

Certified Professional Standards of Excellence:

Practice Management Institute’s Certified Professional Standards of Excellence were developed to promote ethical requirements and standards for its Certified Professionals. These guidelines were established and approved by the Practice Management Institute® Advisory Board for Certification Programming.

Standards of Conduct describe the actions that would reasonably be expected of a PMI Certified Professional in the performance of his/her duties. Certified Professionals are held to the highest professional standards in the medical industry. PMI Certified Professionals must agree to follow appropriate and legal guidelines according to governmental and third party payer organizations and contracts. They will support the compliance efforts and reporting system of the medical practice. They will bill only for services that are actually rendered. Services will be coded accurately and only when documentation is provided for the service. They agree to continue to learn and abide by current standards in the ever-changing business of medicine.

 

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