Passing the CIC exam requires you to correctly answer a minimum of 70% of the questions from the domains below. The exam will rely on a level of understanding that enables you to identify the domain.

Medical Record and Healthcare Documentation Guidelines (7 multiple choice questions)
Recognize the limitations of EHR and how downtime is handled
Identify documentation deficiencies caused by copy/paste and use of templates
Explain HIPAA security and privacy
Define the reporting requirements under MDS
Demonstrate the proper procedure for addendums and alterations to the medial record
Identify components of the medical record
Identify the requirement for timely documentation
Recognize and properly code for procedures performed at the bedside
List the reporting requirements under UHDDS
Identify Joint Commission (JC) requirements for documentation

Medical Terminology, Anatomy and Pathophysiology (3 multiple choice questions)
Define and apply medical terminology and anatomy
Identify pathophysiology to capture correct codes and identify documentation deficiencies
Recognize medications and conditions/diagnoses they are used to treat

Inpatient Coding (7 multiple choice questions)
Identify benefits of computer assisted coding (CAC)
Explain what natural language processing is and which departments in the hospital use it
Apply Coding Clinic guidance to inpatient coding
Identify correct ICD-10-CM and ICD-10-PCS codes for cases done
Identify proper procedure to look up DRGs (e.g., book, grouper)
Explain emerging roles for inpatient coders (DRG validator, auditor)
Identify conditions POA and use of indicators

Inpatient Payment Methodologies (9 multiple choice questions)
Recognize proper procedure for compliance with the two-midnight rule and certification requirements
Define different bill types
Identify information found in a charge master
List examples of auto population of services using a charge master
Explain requirements to maintain and monitor the chargemaster
Define the role each department plays in chargemaster maintenance
Explain the 72-hour rule (24-hour for other types of inpatient services) and how services occurring prior to admit are reported
Identify different types of disposition and the impact on coding
Calculate base payments for DRGs
Identify elements needed to determine DRG assignment
Define what is supported in the DRG (e.g., services performed at another facility)
List and explain different types of DRGs (e.g., APR-DRG)
Identify Medicare code edits
Define different inpatient types
Explain and apply guidelines for selecting the principal diagnosis for different inpatient facilities
Explain impact of readmissions in a 30-day period
Explain when to rebill inpatient claim as an outpatient claim
Identify data submitted on a UB-04

Outpatient Payment Methodology (3 multiple choice questions)
Identify differences between outpatient and inpatient payment methodologies
Explain coding requirements under OPPS: Pass through payments
Explain coding requirements under OPPS: APCs and status Indicators

Regulatory and Payer Requirements (6 multiple choice questions)
Review LCD/NCD and apply the policy to inpatient coding
Identify services covered by Medicare Parts A, B, C, D
Explain proper execution of the ABN and HINN
Review private payer policy and apply to inpatient payment
Identify precertification requirements

Compliance (5 multiple choice questions)
Explain external payer audits process and responsibilities of hospital staff
Explain internal audits and how they relate to compliance plans
Know how to interact with auditors during an onsite audit
Identify audit targets on the OIG Work Plan
Explain the CERT audit process and requirements for response to a request for records
Explain the PEPPER report and how it is used
Identify examples of fraud and abuse
Explain the MAC audit process
Identify services approved for audit by the RAC auditors
Explain the Medicare appeal process and discuss requirements at each level
Explain the RAC audit process and requirements for response to a request for records

Coding Cases (7 cases; fill-in-the-blank questions)
Code the ICD-10-CM and ICD-10-PCS codes for seven inpatient cases
Each case will have anywhere from 5-15 possible answers. Each answer is weighted the same