CMC Cheat Sheet 2026

The 30 highest-yield CMC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What does the term 'code also' mean in coding guidelines? → Another code may be required
2. Which federal regulation governs the Medicare Advantage (Part C) program's coding and risk adjustment requirements? → 42 CFR Part 422
3. Which suffix means 'surgical fixation' or 'to fix in place'? → -pexy
4. When coding a neoplasm, what information from the medical record is most critical for selecting the correct code? → Behavior (malignant, benign, uncertain, unspecified) and site
5. Which documentation practice is most important for quality assurance & performance improvement in the CMC field? → Maintaining complete, accurate, and timely records
6. What is the primary purpose of quality assurance & performance improvement in the context of Certified Medical Coder? → To ensure consistent quality and professional accountability
7. In ICD-10-CM, how should a condition described as 'probable' be coded in the outpatient setting? → Code the signs and symptoms, not the unconfirmed diagnosis
8. What does the acronym HCPCS stand for? → Healthcare Common Procedure Coding System
9. What is the significance of peer review in quality assurance & performance improvement for CMC professionals? → It promotes accountability, knowledge sharing, and quality improvement
10. In Certified Medical Coder, what role does quality assurance & performance improvement play in ensuring client/stakeholder satisfaction? → It builds trust through demonstrated competence and consistency
11. What is the primary purpose of a Remittance Advice (RA) sent to a provider? → To detail how claims were adjudicated and the amounts paid or denied
12. CPT code 99213 is a typical example of which type of service? → Office or other outpatient established patient visit
13. What is the global surgery package in CPT coding? → A defined period of pre- and post-operative care included in the surgical fee
14. Under ICD-10-CM guidelines, how should a coder handle a documented BMI in relation to an obesity diagnosis? → Assign the obesity code first, then add the BMI code as additional
15. The prefix 'erythro-' pertains to which color? → Red
16. Under HIPAA, which action by a covered entity constitutes a breach requiring patient notification? → An employee viewing a celebrity patient's records out of curiosity
17. The National Correct Coding Initiative (NCCI) edits are designed to prevent which type of billing abuse? → Unbundling procedures that should be billed together
18. Which HCPCS Level II code section covers ambulance and other transportation services? → A codes
19. Which documentation practice is most important for evidence-based practice & research methods in the CMC field? → Maintaining complete, accurate, and timely records
20. What is a common challenge professionals face when applying quality assurance & performance improvement principles in Certified Medical Coder? → Balancing theoretical knowledge with practical application
21. A Medicare patient receives a power wheelchair. Which HCPCS Level II code range is most appropriate? → E codes (DME)
22. Which ICD-10-CM code category is used to report encounters for health supervision of newborns? → Z38
23. When coding a condition described as 'probable' or 'suspected' in an outpatient setting, what should the coder assign? → The sign or symptom code
24. Which quality improvement method is most applicable to professional ethics & legal compliance in Certified Medical Coder? → Plan-Do-Check-Act (PDCA) continuous improvement cycle
25. The right and left hypochondriac regions are located in which part of the abdomen? → Upper lateral regions
26. Which section of the ICD-10-CM manual is used to locate diagnosis codes alphabetically? → Alphabetic Index
27. Which HCPCS Level II code category covers orthotic and prosthetic devices? → L codes
28. Which combining form relates to the gallbladder? → Cholecyst/o
29. Which CMS program targets improper payments by using data analytics to identify and stop fraudulent claims before payment is made? → Fraud Prevention System (FPS)
30. How should a CMC professional handle a situation where evidence-based practice & research methods protocols conflict with practical constraints? → Document the conflict and seek guidance from appropriate authorities