NHA CCMA Exam: Key Medical, Insurance, and Coding Concepts

ROI

Authorization to release patient records.

Informed Consent

Patient agrees to procedure after risks explained.

CMS‑1500

Standard insurance billing form.

NPI

10‑digit provider identification number.

ABN

Notice Medicare may not cover service.

EOB

Insurance statement of what was paid/owed.

Advance Directive

Patient wishes for medical care if incapacitated.

HMO

Must use network providers; referrals required.

PPO

More flexibility; higher cost out‑of‑network.

Medicare

Federal insurance for 65+ or disabled.

Medicaid

Insurance for low‑income individuals.

TRICARE

Military insurance.

Workers' Compensation

Covers work‑related injuries.

HIPAA Basics

Protects patient privacy and medical records.

Injections SC

45-90°, 25-27 gauge, insulin, abdomen/arm/thigh.

Injections IM

90°, 20-25 gauge, vaccines, deltoid/vastus lateralis.

Injections ID

10-15°, TB test, inner forearm.

P Wave

Atrial depolarization.

QRS Complex

Ventricular depolarization.

T Wave

Ventricular repolarization.

Heart Rate Calculations 6‑Second Method

Count QRS in 6 sec × 10.

Heart Rate Calculations 1500 Method

1500 ÷ small boxes between R waves.

Capillary puncture

Clean, puncture side of finger, wipe first drop, collect sample.

Sodium Citrate

Coagulation tests.

EDTA

CBC/hematology.

Lithium Heparin

Plasma chemistry.

FEV

Air exhaled in 1 second.

Tidal Volume

Normal breathing air.

Peak Flow Meter

Asthma airflow measurement.

Spirometer

Lung function testing.

Analgesic

Pain relief.

Antipyretic

Fever reducer.

Anticoagulant

Prevents clotting.

Antipruritic

Relieves itching.

Topical

Skin.

Parenteral

Injection.

Buccal

Cheek.

Sublingual

Under tongue.

Controlled Substance Schedule I

No medical use (heroin).

Controlled Substance Schedule II

High abuse (morphine).

Controlled Substance Schedule III

Moderate abuse (codeine combos).

Controlled Substance Schedule IV

Low abuse (Xanax).

Controlled Substance Schedule V

Lowest abuse (cough syrup w/codeine).

Normal Vital Signs Temperature

97.6-99.6°F.

Normal Vital Signs Pulse

60-100 bpm.

Normal Vital Signs Respirations

12-20/min.

Normal Vital Signs Blood Pressure

<120/80 mmHg.

CPT

Procedure codes.

ICD‑10

Diagnosis codes.

HCPCS

Supplies/services.

CPT Sections

Evaluation & Management, Anesthesia, Surgery, Radiology, Pathology/Lab, and Medicine

Upcoding

Billing for higher service (fraud).

Downcoding

Billing lower service.

Dosage Calculation Formula

Desired ÷ Have × Quantity.

Dosage Calculation Example

Order 250 mg, Have 500 mg tablet → 0.5 tablet.

Exam Tips

Know EKG strip identification, dosage calculations, injection angles, and memorize normal vital signs.

Evaluation and Management (E/M)

Anesthesiology Surgery Badiology Pathdogy Laboratory 70010-74999 Medicine