NHA CCMA cheat sheet

Normal adult vital-sign ranges: oral temperature 97.6–99.6 °F (36.5–37.5 °C), pulse 60–100 beats/min, respirations 12–20 breaths/min, blood pressure less than 120/80 mmHg, SpO2 95–100% on room air.

Pulse sites in order of common use: radial, brachial, carotid, temporal, femoral, popliteal, dorsalis pedis, apical; count 30 seconds and multiply by 2 for a regular rhythm, count a full 60 seconds for irregular rhythms.

Blood pressure cuff bladder should encircle about 80% of the upper arm circumference and cover roughly two-thirds of the upper arm length; a cuff that is too small falsely raises the reading.

Needle gauge and length by route: intradermal 26–27 G with a 3/8–5/8 inch needle at a 5–15 degree angle; subcutaneous 25–27 G, 3/8–5/8 inch, 45–90 degrees; intramuscular 20–23 G, 1–1.5 inch, 90 degrees.

Intramuscular injection sites and landmarks: deltoid, 1–2 inches below the acromion process; ventrogluteal, palm on the greater trochanter with index finger on the anterior superior iliac spine; vastus lateralis for infants.

Order of draw for capillary and venipuncture specimens: blood cultures, then light blue (citrate), serum tubes (red/gold), heparin tubes (green), EDTA tubes (lavender), and glycolytic inhibitor tubes (gray).

Universal precautions treat all blood and body fluids as infectious; gloves for all contact, hand hygiene before and after gloves, and a mask with eye protection when splash exposure is likely.

Medical asepsis reduces organisms (hand washing, disinfection), while surgical asepsis destroys all microorganisms and is required for sterile procedures such as urinary catheterization and dressing changes on open wounds.

ECG basics: normal sinus rhythm has a P wave before every QRS, a PR interval of 0.12–0.20 seconds, and a QRS of less than 0.12 seconds; the paper speed standard is 25 mm per second.

Medical record ownership: the physical or electronic record belongs to the practice, but the patient owns the information and holds the right of access and amendment under HIPAA.

HIPAA Privacy Rule permits disclosure without authorization for treatment, payment, and health care operations, plus required reporting such as communicable disease and suspected abuse.

Release of protected health information generally requires a signed authorization naming the information, recipient, purpose, and expiration date; psychotherapy notes need separate authorization.

Scheduling rule of thumb: divide total available minutes by average visit length to set slots, and block acute same-day appointments so urgent visits do not displace established follow-ups.

Accounts receivable aging: 0–30, 31–60, 61–90, and over 90 days; claims typically must be submitted within the payer's timely filing limit, often 90–365 days from the date of service.

EOB versus remittance advice: an explanation of benefits goes to the patient, while the remittance advice goes to the provider and explains payment, adjustments, and denials.

Common claim denials trace to missing eligibility verification, incorrect diagnosis-to-procedure linkage, absent prior authorization, and duplicate billing; verify eligibility before the visit to prevent the majority.

Coordination of benefits: for a dependent child, the custodial parent's plan pays first; when both parents share joint custody, the birthday rule gives primary status to the parent whose birthday falls earlier in the year.

Medicare Part B covers physician and outpatient services with a monthly premium, while Part A covers inpatient hospital care; Medicaid is a joint federal-state program with income-based eligibility.

Normal adult vital-sign ranges: oral temperature 97.6–99.6 °F (36.5–37.5 °C), pulse 60–100 beats/min, respirations 12–20 breaths/min, blood pressure less than 120/80 mmHg, SpO2 95–100% on room air.

Pulse sites in order of common use: radial, brachial, carotid, temporal, femoral, popliteal, dorsalis pedis, apical; count 30 seconds and multiply by 2 for a regular rhythm, count a full 60 seconds for irregular rhythms.

Blood pressure cuff bladder should encircle about 80% of the upper arm circumference and cover roughly two-thirds of the upper arm length; a cuff that is too small falsely raises the reading.

Needle gauge and length by route: intradermal 26–27 G with a 3/8–5/8 inch needle at a 5–15 degree angle; subcutaneous 25–27 G, 3/8–5/8 inch, 45–90 degrees; intramuscular 20–23 G, 1–1.5 inch, 90 degrees.

Intramuscular injection sites and landmarks: deltoid, 1–2 inches below the acromion process; ventrogluteal, palm on the greater trochanter with index finger on the anterior superior iliac spine; vastus lateralis for infants.

Order of draw for capillary and venipuncture specimens: blood cultures, then light blue (citrate), serum tubes (red/gold), heparin tubes (green), EDTA tubes (lavender), and glycolytic inhibitor tubes (gray).

Universal precautions treat all blood and body fluids as infectious; gloves for all contact, hand hygiene before and after gloves, and a mask with eye protection when splash exposure is likely.

Medical asepsis reduces organisms (hand washing, disinfection), while surgical asepsis destroys all microorganisms and is required for sterile procedures such as urinary catheterization and dressing changes on open wounds.

ECG basics: normal sinus rhythm has a P wave before every QRS, a PR interval of 0.12–0.20 seconds, and a QRS of less than 0.12 seconds; the paper speed standard is 25 mm per second.

Medical record ownership: the physical or electronic record belongs to the practice, but the patient owns the information and holds the right of access and amendment under HIPAA.

HIPAA Privacy Rule permits disclosure without authorization for treatment, payment, and health care operations, plus required reporting such as communicable disease and suspected abuse.

Release of protected health information generally requires a signed authorization naming the information, recipient, purpose, and expiration date; psychotherapy notes need separate authorization.

Scheduling rule of thumb: divide total available minutes by average visit length to set slots, and block acute same-day appointments so urgent visits do not displace established follow-ups.

Accounts receivable aging: 0–30, 31–60, 61–90, and over 90 days; claims typically must be submitted within the payer's timely filing limit, often 90–365 days from the date of service.

EOB versus remittance advice: an explanation of benefits goes to the patient, while the remittance advice goes to the provider and explains payment, adjustments, and denials.

Common claim denials trace to missing eligibility verification, incorrect diagnosis-to-procedure linkage, absent prior authorization, and duplicate billing; verify eligibility before the visit to prevent the majority.

Coordination of benefits: for a dependent child, the custodial parent's plan pays first; when both parents share joint custody, the birthday rule gives primary status to the parent whose birthday falls earlier in the year.

Medicare Part B covers physician and outpatient services with a monthly premium, while Part A covers inpatient hospital care; Medicaid is a joint federal-state program with income-based eligibility.