ccma review

ICD-10-CM

The International Classification of Diseases, 10th Revision- global standard for diagnosing and coding diseases and diagnoses.

ICD-10-CM Format

3-7 characters, 1st is a letter, 2 and 3 are numbers, rest are mixed.

CPT

Current Procedural Terminology- system for coding medical procedures and services.

CPT Format

Cat 1- 5 numbers

Cat II- 4 numbers with F

Cat III- 4 numbers with T

What falls under each category for CPT codes?

Cat 1- widely performed procedures

Cat 2- tracking for performance and quality of service/procedure

Cat 3- temporary code for newly emerging procedures

Modifiers

2 digits added to a CPT or HCPCS code to provide extra information regarding service

V1 lead placement?

Right of sternum, 4th intercostal space

V2 lead placement?

Left of sternum, 4th intercostal space

V4 lead placement?

Left of chest, 5th intercostal space at midclavicular cline

V3 lead placement?

Left of chest, halfway between V2 and V4

V5 lead placement?

Left of chest, 5th intercostal space at anterior axillary line

V6 lead placement?

Left of chest, 5th intercostal space at midaxillary line

How should leads be applied for an EKG?

Clean and dry skin, clip or shave hair, wires without tension

What direction should tabs face on leads?

Limb electrodes- towards the midline/torso

Precoridal electrodes- downward towards feet

Define each wave of the cardiac cycle

P wave: atrial depolarizatio

QRS wave: ventricular depolarization (and atrial repolarization)

T wave: ventricular repolarization

U wave: repolarization of bundle of His and purkinje fibers

Normal values for hemoglobin?

males- 13-18 g/dL

females- 12-16 g/dL

Normal values for hematocrit?

males: 42-52%

females: 36-48%

Normal values for fasting blood sugar?

60-110 mg/dL

Normal values for total cholesterol?

under 200 mg/dL

Normal values for LDL?

under 130 mg/dL

Normal value for HDL?

over 40 mg/dL

Normal values for triglycerides?

under 150 mg/dL

Normal value for ESR?

males: 0-20 mm/hr

females: 0-30 mm/hr

Normal values for INR?

0.8-1.2

Normal values for prothrombin time?

10.4-15.7 seconds

Normal values for urine (pH, specific gravity, urobilinogen)?

pH: 4.5-8

specific gravity: 1.005-1.03

urobilinogen: 0.1-1

any other values should be negative

What is the rinne test?

strike tuning fork and place behind ear on mastoid bone, patient raises hand when no longer hearing sound

What is the weber test?

strike tuning fork and place on midline at forehead/chin, ask patient if sound is louder of left/right side or equal

Inches to cm conversion

1inch = 2.54 cm

Fowlers position

sitting up, head of bed elevated 90 degrees

Semi-fowlers position

sitting up, head of bed elevated at 45 degrees

Sims position

laying on left side with right leg bent across you- for rectal exams/enemas

Lithotomy position

laying supine with feet elevated/in stirrups- for gynecology exams

Dorsal recumbent position

laying supine with knees bent and feet flat on table

Intradermal injection characteristics

needle: 27-28 gauge, 3/8 inch

injection: 10-15 degrees, typically on forearm (back for allergy testing)

Subcutaneous injection characteristics

needle: 25-26 gauge, ½ inch- 5/8 inch

injection: 45 degrees (unless obsese), done on upper arm, abdomen, thigh

massage site ONLY for heparin/insulin injections

Intramuscular injection characteristics

needle: 20-23 gauge, 1-3 inches

injection: 90 degrees, massage site after injection, done on glutes, thigh, upper arm

Atrial fibrillation vs ventricular fibrillation?

Afib- increased risk of stroke, blood clots; dangerous but not life-threatening

Vfib- leads to cardiac arrest, start CPR immediately

Equipment that only requires sanitization?

only contacts intact skin; stethoscope, bp cuff, pulse ox

Equipment that only needs sanitization and disinfection?

contact mucuous membranes or broken skin; endotrach tubes, speculums, ent equipment

What is the chain of custody used for?

To maintain control over nonblood specimens as they are transported and tested, NOT used for blood cultures

What are helminthic pathogens?

“worms”- ringworm, pinworms, tapeworms

What are common pathogenic viruses?

adenovirus, EB (mono), hepatitis, herpes simplex, measles, mumps, rabies, rubella, zaricella zoster

What are common pathogenic parasites?

pediculosis (lice), pubic lice, crabs

Full block format

All lines flush with left margin

Modified block format

address and body are flush left, everything else centered

simplified format

information is aligned left with no salutation or closing

Order of draw for venipuncture

yellow- blood cultures

light blue- sodium citrate

red-

gold- serum separator or clot activator

green- sodium or lithium heparin

lavender- EDTA

grey- potassium oxalate and sodium fluroide- glucose testing

normal value for BUN?

6-20 mg/dL

normal values for sodium?

136-145 mEq/L

normal values for potassium?

3.5-5.1 mEq/L

Normal values for RBCs?

males: 4.7-6.1 × 10^6

females: 4.2-5.4 × 10^6