CCMA Exam

advance beneficiary notice

• a form provided to the patient when the provider believes Medicare will probably not pay for services recieved

allowed amount

• the maximum amount a third-party payer will pay for a particular procedure or service

copayment

• an amount of money that is paid at the time of medical service

coinsurance

• a policy provision frequently found in medical insurance whereby the policyholder and the insurance company share the cost of covered losses in a specified ratio, such as 80:20

deductible

• a specific amount of money a patient must pay out of pocket before the insurance carrier begins paying

explanation of benefits

• a statement from the insurance carrier detailing what was paid, denied, or reduced in payment; also contains information about amounts applied to the deductible, coinsurance, and allowed amounts

participating provider (PAR)

• providers who agree to write off the difference between the amount charged by the provider and the approved fee established by the insurer

medicare

• generally covers patients age 65 and older by Part A (hospitalization) or Part B (routine medical office visits) benefits

tricare

• authorizes dependents of military personnel to receive treatment from civilian providers at the expense of the federal government

CHAMPVA

• covers surviving spouses and dependent children of veterans who died as a result of service-related disabilities

medicaid

• provides health insurance to the medically indigent population through a cost-sharing program between federal and state governments for those who meet specific eligibility criteria

managed care

• an umbrella tern for plans that provide health care in return for preset scheduled payments and coordinated care through a defined network of providers and hospitals

workers’ compensation

• products wage earners against the loss of wages and the cost of medical care resulting from an occupational accident or disease as long as the employee is not proven negligent

CMS-1500 Form

• claims submitted by a provider or supplier

CMS-1500 Form Section 1

• carrier block

• contains the address of the insurance carrier and is located at the top of the form

CMS-1500 Form Section 2

• patient/insured section

• contains information about the patient or insured

• includes boxes 1 through 13

CMS-1500 Form Section 3

• physician/supplier section

• contains information about the physician or suppler

• includes boxes 14 to 33

Supine

Dorsal Recumbent position

SIms’ position

Knee-elbow position

Fowler’s Position

Lithotomy position

Schedule 1 drugs

• high potential for abuse and no approved medical use in the United States

• heroin, mescaline, and lysergic acid diethylamide

• includes marijuana

Schedule 2 Drugs

• substances that have a high potential for abuse, are considered dangerous and can lead to psychological and physical dependence

• morphine, methadone, oxycodone, hydromorphone, hydrocodone, fentanyl, and methamphetamine

• handwritten prescription with no refills

Schedule 3 drugs

• moderate to low potential for physical and psychological dependence

• ketamine, anabolic steroids, and testosterone

• handwritten prescription and can be refilled five times in 6 months

Schedule 4 drugs

• low potential for abuse and dependence

• diazepam, zolpidem, eszopiclone, alprazolam, chlordiazepoxide, and clonazepam

• can refill five times in six months and refills can be authorized over the phone

Schedule 5 drugs

• substances that contain limited quantities of some narcotics

• usually for antidiarrheal, antitussive, and analgesic purposes

• atropine, pregabalin, lacosamide, and opium/kaolin/pectin/belladonna

• can refill five times in six months and refills can be authorized over the phone

Epidural

• epidural space

• injectable liquid

• not permitted to administer

intra-arterial

• arteries (to break up clots)

• injectable liquid

• not permitted to administer

intra-articular

• within a joint space

• injectable liquid

• not permitted to administer

intradermal

• within a joint space

• injectable liquid

• permitted to inject

intramuscular

• deltoid, vastus lateralis, ventrogluteal muscles

• injectable liquid

• not permitted to administer

introaosseous

• bone marrow

• injectable liquid

• not permitted to administer

intraperitoneal

• peritoneal cavity (abdomen)

• injectable liquid

• not permitted to administer

intrapleural

• pleural space (lungs)

• injectable liquid

• not permitted to administer

intrathecal

• subarachnoid space (brain)

• injectable liquid

• not permitted to administer

intravenous (IV)

• Major veins, most often in the arms and hands or via central venous access devices

• injectable liquid

• not permitted to administer

subcutaneous

• under the skin of the abdomen, anterior thighs, upper outer arm, upper back (under the shoulder)

• injectable liquid

• permitted to administer

Fat soluble vitamins

• a

• d

• e

• k

water-soluble vitamins

• B1

• B2

• B3

• B6

• folate

• B12

• pantothenic acid

• biotin

• C

Erikson’s stage of psychosocial development

• trust/mistrust

• autonomy/shame and doubt

• initiative/guilt

• industry/inferiority

• identity/role confusion

• intimacy/isolation

• generativity/stagnation

• ego integrity/despair

Stages of grief

• denial

• anger

• bargaining

• depression

• acceptance

apathy

• indifference

• lack of interest, feeling, concern, or emotion

compensation

• a method of balancing a failure or inadequacy with an accomplishment

conversion

• transformation of an anxiety into a physical symptom that has no cause

denial

• avoidance of unpleasant or anxiety-provoking situations or ideas by rejecting them or ignoring their existence

displacement

• the redirection of emotions away from its original subject or object onto another less threatening subject or object

disassociation

• a disconnection of emotional importance from ideas or events from compartmentalizing those emotions in different parts of awareness

identification

• the attribution of characteristics of someone else to oneself or the imitation of another

intellectualization

• analysis of a situation with facts and not emotions

introjection

• adoption of the thoughts or feelings of others

physical avoidance

• keeping away from any person, place or object that evokes memories of something unpleasant

projection

• transference of a person’s unpleasant ideas and emotions onto someone or something else

rationalization

• an explanation that makes something negative or unacceptable seem justifiable or acceptable

reaction formation

• belief in and expression of the opposite of one’s true feelings

regression

• the reversion to an earlier, more childlike, developmental behavior

repression

• the elimination of unpleasant emotions, desires, or problems from the conscious mind

sarcasm

• the use of words that have the opposite meaning, especially to be funny, insulting, or irritating

sublimation

• rechanneling unacceptable urges or drives into something constructive or acceptable

suppression

• voluntarily blocking of an unpleasant experience from one’s awareness

undoing

• canceling out an unacceptable behavior with a symbolic gesture

verbal aggression

• a verbal attack on a person without addressing the original intent of the conversation

superior

• above or closer to the head

inferior

• below or closer to the feet

anterior

• toward the front of the body

posterior

• toward the back of the body

medial

• closer to the midline of the body

lateral

• further away from the midline of the body

proximal

• closer to the trunk of the body

distal

• farther away from the trunk

superficial

• closer to the surface of the body

deep

• farther from the body’s surface

travel of electrical impulse

• sinoatrial node (SA)

• atrioventricular node (AV)

• bundle of His

• purkinje fibers

homeostasis

• body’s systems and biological processes maintain stability

chain of infection

• infectious agent

• reservoir host

• portal of exit

• mode of transmission

• portal of entry

• susceptible host

conditions for growth

• moisture

• warmth

• oxygen

• food

• time

average heart rate

• newborn (birth to 1 month) 120 to 160/min

• infant (1 to 12 months) 80 to 140/min

• toddler (1 to 3 years) 80 to 130/min

• Preschool (3 to 5 years) 80 to 120/min

• school-age (6 to 15 years) 70 to 100/min

• Adult (older than 15 years) 60 to 100/min

Pulse Oximetry

• A probe is attached to the finger that incorporates an infrared light

• reading of 95% or higher is considered a normal result

blood pressure

• A sphygmomanometer is used to determine the blood person

• millimeters of mercury

• systolic pressure is recorded when the first sharp tapping sound is heard, which is when the blood begins to surge into the artery that has been occluded by the inflation of the blood pressure cuff

• diastolic pressure is noted when the last sound disappears completely and blood is flowing freely

• diastolic and systolic are stage 1 and 5 of korotkoff sounds

• phase 2 there is a swishing sound as more blood flows through the artery

• phase 3 sharp tapping sounds are noted as more blood is surging

• phase 4 the sound changes to a soft tapping sound

hypertension

• high blood pressure

• anything above 140/90 mmhg

prehypertension

• 120-139/80-89 mm Hg

average blood pressure rates

• infants and children 60-100/30-80 mm Hg

• adults 100-140/60-80 mm Hg

respiration rates

• 28/min

• breathing pattern and depth describe how much air is inhaled

• newborn average 30 to 50/min

• adult rate 12 to 20/min

heart rate

• radial pulse most common site for taking an adult pulse

• brachial pulse most common for children

• carotid most common for use in emergency procedures

deltoid muscle injection

• 1 to 2 inches below the acromion

• 90 degree angle

• do not aspirate vaccines

• aspirate most other types of medications administered via this route

• do not use for infants or children under 3 years old

• should not exceed 1 mL

• massaged after medication is administered

ventrogluteal muscle injection

• place heel of the hand on the greater trochanter (right hand placed on left hip and left hand placed on right hip), middle finger is placed on the iliac crest and the fingers are spread, where the V is made is where the injection goes

• 90 degree angle

• do not aspirate vaccines

• aspirate most other types of medications administered via this route

• deep IM injections are prescribed or when larger quantities of medicines are needed

• viscous medications

vastus lateralis muscle injection

• mid to upper outer thigh

• 90 degree angle

• do not aspirate vaccines

• aspirate most other types of medications administered via this route

• vaccines and medication for people under 3 years old

subcutaneous injection

• multiple subcutaneous tissue sites are readily available for injections

• 45 degree angle

• do not aspirate for vaccines, insulin, or heparin

• aspirate for most other types of medications administered via this route

• when administering insulin or heparin, site should be massaged

• sites should be rotated

• common sites upper outer arm, abdomen, and thigh

intradermal

• for the forearm, one hand width from the wrist and one hand width from the elbow

• any area within the anterior forearm visible is acceptable for the injection

• upper back may be used

• 10 to 15 angle

• do not aspirate

• used for testing

• presence of a wheal is expected

• do not massage or apply pressure

• most common site for TB testing is mid forearm

• allergy testing is done on back

oral medications

• in the mouth

• solids: for multiple-dose bottles, pour pills into the lid first, then the medicine cup

• liquids: read liquids at the lowest point of the curve of the liquid and “palm” the label to prevent distortion if medication drips down the bottle

buccal

• between the cheek and gums resulting in rapid absorption

• medication bypasses the digestive system, resulting in smaller doses required for therapeutic effects

• medication is designed to melt while held in the cheek area

• eating, drinking, or smoking can influence the absorption rate

sublingual

• under the tongue

• nitroglycerin tablets and spray are common forms of medication via this route

• because the medication bypasses the digestive system, smaller doses are require for therapeutic effects

• solids: medication melts and absorbs into the bloodstream rapidly

• liquids: sprays are occasionally used to deliver sublingual medications

• eating, drinking, or smoking can influence absorption rates

inhalation

• typically used for targeted areas such as bronchial passages

• can be delivered via a nebulizer

• patient must hold the medication in lungs as long as possible

topical medications

• designed to react locally and systematic absorption is minimal

• can serve as a barrier to prevent irritants from damaging the skin or can be used to treat a local condition

• typically oil-or-water-based products

• monitor for skin irritation or reaction

mucosal

• designed to absorb into and through mucous membranes

• medications can be administered in the vagina, rectum, eye, or ear

• can cause irritation to the mucosas

transdermal

• for continuous slow absorption of various medications

• used for smoking cessation, pain medication, hormone delivery

• avoid touching the medication when applying the patch

• dispose of the patch in a container that is not accessible to children

• monitor skin for irritation

cryosurgery

• process of exposing tissues to extreme cold temperatures to destroy cells

• may be performed for conditions such as warts or cervical dysplasia

• canister with liquid nitrogen, cryoprobe

colposcopy/hysteroscopy

• using an instrument to inspect the vaginal area and cervix or the uterus and deliver treatments or perform diagnostic testing

• cannot be performed if woman is on period

electrosurgery or electrocauterization

• a pulse of electrical current is sent through tissue to cauterize

• used to minimize or stop bleeding, destroy small polyps, or break scar tissue