IAMI CPMA study guide
IAMI CPMA · Work through your exam, one topic at a time.
The Certified Professional Medical Auditor (CPMA) is a credential for people who review healthcare documentation and claims for accuracy, completeness, and compliance. Candidates typically come from medical coding, billing, practice management, compliance, or clinical backgrounds and want to move into a review or oversight role rather than production coding. The IAMI CPMA study guide has 8 sections and about 2,560 words.
01Coding and Documentation Standards
Coding and Documentation Standards tests whether you can determine if a claim is supported by the medical record and payable under the correct code set and payer rules. You are not rewriting the note; you are testing each code, modifier, unit, diagnosis, and medical-necessity link against written criteria.
356 words, about 2 min02Audit Process and Methodology
Audit Process and Methodology tests the lifecycle of a defensible audit: objective, scope, criteria, data request, sampling, testing, workpapers, findings, reporting, and corrective-action follow-up. The exam favors evidence over opinion.
317 words, about 2 min03Regulatory and Compliance Requirements
Regulatory and Compliance Requirements tests the legal and payer framework an auditor must apply, including false claims, inducements, physician self-referral, privacy, overpayments, and program integrity. The False Claims Act prohibits knowingly presenting or causing a false claim; “knowingly” includes deliberate ignorance and reckless disregard, not only specific intent.
335 words, about 2 min04Medical Record Review and Data Validation
Medical Record Review and Data Validation tests whether you can verify that the record is complete, authentic, contemporaneous, and internally consistent with the claim and other data sources. Confirm patient identity, date of service, provider identity and credentials, setting, and authentication.
331 words, about 2 min05Audit Reporting and Communication
Audit Reporting and Communication tests whether findings are clear, evidence-based, and actionable without overstating certainty or accusing individuals of fraud. A defensible report states the objective, scope, period, sample method, criteria, methodology, findings, risk, root cause, recommendations, and management response.
301 words, about 2 min06Fraud, Waste, and Abuse Detection and Prevention
Fraud, Waste, and Abuse Detection and Prevention tests your ability to distinguish intent, recognize schemes, use data signals, and build controls that prevent recurrence. Fraud is intentional deception or misrepresentation that may result in unauthorized benefit.
303 words, about 2 min07Ethics, Independence, and Professional Conduct
Ethics, Independence, and Professional Conduct tests whether an auditor can remain objective, confidential, competent, and resistant to pressure while producing accurate work. Independence means independence in fact and appearance.
306 words, about 2 min08Audit Planning, Sampling, and Risk Assessment
Audit Planning, Sampling, and Risk Assessment tests how you choose what to audit, how much to review, and how to defend the resulting conclusions. Risk assessment should be documented before sampling.
311 words, about 2 min