Exam Content Outline

The exam candidate's navigation tool for study, the content outline lists the subject matter covered in the CMA (AAMA)® Certification Exam by topic category.

Additionally, the content outline includes the number and percent of questions on the exam by major content areas.

Based on the AAMA 2018–2019 Occupational Analysis of Medical Assistants, a new edition of the Content Outline for the CMA (AAMA)® Certification Exam has been published!

Using research-based data from the Occupational Analysis, the Certifying Board (CB) of the AAMA condensed subdomains within the Content Outline to more accurately reflect medical assistants’ duties and required skills. Notably, the percentage of clinical competency questions has increased, while the percentage of general and administrative questions has lowered slightly.

Note: The updated Content Outline will go into effect on July 15, 2021. If you plan to take the CMA (AAMA) Certification Exam before July 15, 2021, you should continue to use the previous Content Outline to study for the exam. If you will take the exam on or after July 15, 2021, use the updated Content Outline.

Content Outline for the CMA (AAMA)® Certification Exam (effective through 7/14/21)

I. A–G General

A. Psychology

1. Understanding Human Behavior
a. Behavioral theories
(1) Maslow
(2) Erikson
b. Defense mechanisms
(1) Common types
(2) Recognition and management

2. Human Growth and Development
a. Normal developmental patterns/milestones

3. Death and Dying Stages

B. Communication

1. Therapeutic/Adaptive Responses to Diverse Populations
a. Visually impaired
b. Hearing impaired
c. Age specific
(1) Geriatric
(2) Pediatric/adolescent
d. Seriously/terminally ill
e. Intellectual disability
f. Illiterate
g. Non-English speaking
h. Anxious/angry/distraught
i. Socially/culturally/ethnically diverse

2. Nonverbal Communication
a. Body language
(1) Posture
(2) Position
(3) Facial expression
(4) Territoriality/physical boundaries
(5) Gestures
(6) Touch
(7) Mannerisms
(8) Eye contact

3. Communication Cycle
a. Sender-message-receiver-feedback
b.Listening skills
(1) Active/therapeutic
c. Assess level of understanding
(1) Reflection
(2) Restatement
(3) Clarification
(4) Feedback
d. Barriers to communication
(1) Internal distractions
(a) Pain
(b) Hunger
(c) Anger
(2) External/environmental distractions
(a) Temperature
(b) Noise

4. Collection of Data
a. Types of questions
(1) Exploratory
(2) Open-ended
(3) Closed/Direct

5. Telephone Techniques
a. Call management
(1) Screening/gathering data
(2) Emergency/urgent situations
b. Messages
(1) Taking messages
(2) Leaving messages

6. Interpersonal Skills
a. Displaying impartial conduct without regard to race, religion, age, gender, sexual orientation, socioeconomic status, physical challenges, special needs, lifestyle choices
b. Recognizing stereotypes and biases
c. Demonstrating empathy/sympathy/compassion

C. Professionalism

1. Professional Behavior
a. Professional situations
(1) Displaying tact, diplomacy, courtesy, respect, dignity
(2) Demonstrating responsibility, integrity/honesty
(3) Responding to criticism
b. Professional image

2. Performing as a Team Member
a. Principles of health care team dynamics
(1) Cooperation for optimal outcomes
(2) Identification of the roles and credentials of health care team members
b. Time management principles
(1) Prioritizing responsibilities

D. Medical Law/Regulatory Guidelines

1. Advance Directives
a. Living will
b. Medical durable power of attorney
c. Patient Self-Determination Act (PSDA)

2. Uniform Anatomical Gift Act

3. Occupational Safety and Health Administration (OSHA) 

4. Food and Drug Administration (FDA)

5. Clinical Laboratory Improvement Act (CLIA '88)

6. Americans with Disabilities Act Amendments Act (ADAAA)

7. Health Insurance Portability and Accountability Act (HIPAA)
a. Health insurance portability access and renewal without preexisting conditions 
b. Coordination of care to prevent duplication of services

8. Health Information Technology for Economic and Clinical Health (HITECH) Act
a. Patient's right to inspect, amend, and restrict access to his/her medical record

9. Drug Enforcement Agency (DEA)
a. Controlled Substances Act of 1970

10. Medical Assistant Scope of Practice
a. Consequences of failing to operate within scope

11. Genetic Information Nondiscrimination Act of 2008 (GINA)

12. Centers for Disease Control and Prevention (CDC)

13. Consumer Protection Acts
a. Fair Debt Collection Practices Act
b. Truth in Lending Act of 1968 (Regulation Z)

14. Public Health and Welfare Disclosure
a. Public health statutes
(1) Communicable diseases
(2) Vital statistics
(3) Abuse/neglect/exploitation against child/elder
(a) Domestic abuse
(4) Wounds of violence

15. Confidentiality
a. Electronic access audit/activity log
b. Use and disclosure of personal/protected health information (PHI)
(1) Consent/authorization to release
(2) Drug and alcohol treatment records
(3) HIV-related information
(4) Mental health

16. Health Care Rights and Responsibilities
a. Patients' Bill of Rights/Patient Care Partnership
b. Professional liability
(1) Current standard of care
(2) Standards of conduct
(3) Malpractice coverage
c. Consent to treat
(1) Informed consent
(2) Implied consent
(3) Expressed consent
(4) Patient incompetence
(5) Emancipated minor
(6) Mature minor

17. Medicolegal Terms and Doctrines
a. Subpoena duces tecum
b. Subpoena
c. Respondeat superior
d. Res ipsa loquitor
e. Locum tenens
f. Defendant-plaintiff
g. Deposition
h. Arbitration-mediation
i. Good Samaritan laws

18. Categories of Law
a. Criminal law
(1) Felony/misdemeanor
b. Civil law
(1) Contracts (physician-patient relationships)
(a) Legal obligations to the patient
(b) Consequences for patient noncompliance
(c) Termination of medical care
(i) Elements/behaviors for withdrawal of care
(ii) Patient notification and documentation
(d) Ownership of medical records
(2) Torts
(a) Invasion of privacy
(b) Negligence
(c) Intentional torts
(i) Battery
(ii) Assault
(iii) Slander
(iv) Libel
c. Statutory law
(1) Medical practice acts
d. Common law (Legal precedents)

E. Medical Ethics

1. Ethical Standards

2. Factors Affecting Ethical Decisions
a. Legal
b. Moral

F. Risk Management, Quality Assurance, and Safety

1. Workplace Accident Prevention
a. Slips/trips/falls

2. Safety Signs, Symbols, Labels

3. Environmental Safety
a. Ergonomics
b. Electrical safety
c. Fire prevention/extinguisher use/regulations

4. Compliance Reporting
a. Reporting unsafe activities and behaviors
b. Disclosing errors in patient care
c. Insurance fraud, waste, and abuse
d. Conflicts of interest
e. Incident reports

G. Medical Terminology

1. Word Parts
a. Basic structure
(1) Roots/combining forms
(2) Prefixes
(3) Suffixes

2. Definitions/Medical Terminology
a. Diseases and pathologies
b. Diagnostic procedures
c. Surgical procedures
d. Medical specialties

II. H-M Administrative

H. Medical Reception

1. Medical Record Preparation

2. Demographic Data Review
a. Identity theft prevention
b. Insurance eligibility verification

3. Handling Vendors/Business Associates

4. Reception Room Environment
a. Comfort
b. Safety
c. Sanitation

5. Practice Information Packet
a. Office policies
b. Patient financial responsibilities

I. Patient Navigator/Advocate

1. Resource Information
a. Provide information about community resources
b. Facilitate referrals to community resources
c. Referral follow-up

J. Medical Business Practices

1. Written Communication
a. Letters
b. Memos/interoffice communications
c. Reports

2. Business Equipment
a. Routine maintenance
b. Safety precautions

3. Office Supply Inventory
a. Inventory control/recordkeeping

4. Electronic Applications
a. Medical management systems
(1) Database reports
(2) Meaningful use regulations
b. Spreadsheets, graphs
c. Electronic mail
d. Security
(1) Password/screen saver
(2) Encryption
(3) Firewall
e. Transmission of information
(1) Facsimile/scanner
(2) Patient portal to health data
f. Social media

K. Establish Patient Medical Record

1. Recognize and Interpret Data
a. History and physical
b. Discharge summary
c. Operative note
d. Diagnostic test/lab report
e. Clinic progress note
f. Consultation report
g. Correspondence
h. Charts, graphs, tables
i. Flow sheet

2. Charting Systems
a. Problem-oriented medical record (POMR)
b. Source-oriented medical record (SOMR)

L. Scheduling Appointments

1. Scheduling Guidelines
a. Appointment matrix
b. New patient appointments
(1) Identify required information
c. Established patient appointments
(1) Routine
(2) Urgent/emergency
d. Patient flow
(1) Patient needs/preference
(2) Physician preference
(3) Facility/equipment requirements
e. Outside services (e.g., lab, X-ray, surgery, outpatient procedures, hospital admissions)

2. Appointment Protocols
a. Legal aspects
b. Physician referrals
c. Cancellations/no-shows
d. Physician delay/unavailability
e. Reminders/recall systems
(1) Appointment cards
(2) Phone calls/text messages/e-mail notifications
(3) Tickler file

M. Practice Finances

1. Financial Terminology
a. Accounts receivable
b. Accounts payable
c. Assets
d. Liabilities
e. Aging of accounts
f. Debits
g. Credits
h. Diagnosis Related Groups (DRGs)
i. Relative Value Units (RVUs)

2. Financial Procedures
a. Payment receipts
(1) Co-pays
b. Data entry
(1) Post charges
(2) Post payments
(3) Post adjustments
c. Manage petty cash account
d. Financial calculations
e. Billing procedures
(1) Itemized statements
(2) Billing cycles
f. Collection procedures
(1) Aging of accounts
(2) Preplanned payment options
(3) Credit arrangements
(4) Use of collection agencies

3. Diagnostic and Procedural Coding Applications
a. Current Procedural Terminology (CPT)
(1) Modifiers
(2) Upcoding
(3) Bundling of charges
b. International Classification of Diseases, Clinical Modifications (ICD-CM) (Current schedule)
c. Linking procedure and diagnosis codes
d. Healthcare Common Procedure Coding System (HCPCS Level II)

4. Third-Party Payers/Insurance
a. Types of plans
(1) Commercial plans
(2) Government plans
(a) Medicare
(i) Advance Beneficiary Notice (ABN)
(b) Medicaid
(3) Managed care organizations (MCOs)
(a) Managed care requirements
(i) Care referrals
(ii) Precertification
[a] Diagnostic and surgical procedures
(iii) Prior authorization
[a] Medications
(4) Workers' compensation
b. Insurance claims
(1) Submission
(2) Appeals/denials
(3) Explanation of benefits (EOB)

III. N-V Clinical

N. Anatomy and Physiology

1. Body as a Whole
a. Structural units
b. Anatomical divisions, body cavities
c. Anatomical positions and directions
d. Body planes, quadrants

2. Body Systems Including Normal Structure, Function, and Interrelationships Across the Life Span
a. Integumentary
b. Musculoskeletal
c. Nervous
d. Cardiovascular, hematopoietic, and lymphatic
e. Respiratory
f. Digestive
g. Urinary
h. Reproductive
i. Endocrine
j. Sensory

3. Pathophysiology and Diseases of Body Systems
a. Integumentary
b. Musculoskeletal
c. Nervous
d. Cardiovascular, hemtopoietic, and lymphatic
e. Respiratory
f. Digestive
g. Urinary
h. Reproductive
i. Endocrine
j. Sensory

O. Infection Control

1. Infectious Agents
a. Bacteria
b. Viruses
c. Protozoa
d. Fungi
e. Parasites

2. Modes of Transmission
a. Direct
b. Indirect
c. Airborne
d. Droplet
e. Inhalation

3. Infection Cycle/Chain of Infection

4. Body's Natural Barriers

5. Medical Asepsis
a. Hand hygiene
(1) Hand washing
(2) Alcohol-based hand rub
b. Sanitization
c. Disinfection

6. Surgical Asepsis
a. Surgical scrub
b. Sterilization techniques/Autoclave
(1) Preparing items
(2) Wrapping
(3) Sterilization indicators

7. Standard Precautions/Blood-borne Pathogen Standards
a. Body fluids
b. Secretions
c. Excretions
d. Blood
e. Mucous membranes
f. Personal protective equipment (PPE)
(1) Gowns
(2) Gloves
(3) Masks
(4) Caps
(5) Eye protection
g. Post-exposure plan

8. Biohazard Disposal/Regulated Waste
a. Sharps
b. Blood and body fluids
c. Safety data sheets (SDS)
d. Spill kit

P. Patient Intake and Documentation of Care

1. Medical Record Documentation
a. Subjective data 
(1) Chief complaint
(2) Present illness
(3) Past medical history
(4) Family history
(5) Social and occupational history
(6) Review of systems
b. Objective data
c. Making corrections
d. Treatment/compliance

Q. Patient Preparation and Assisting the Provider

1. Vital Signs/Anthropometrics
a. Blood pressure
(1) Technique
(2) Equipment
(a) Stethoscope
(b) Sphygmomanometer
b. Pulse
(1) Technique
(a) Pulse points
(b) Rate and rhythm
c. Height/weight/BMI
(1) Technique
(2) Equipment
d. Body temperature
(1) Technique
(2) Equipment
e. Oxygen saturation/pulse oximetry
(1) Technique
(2) Equipment
f. Respiration rate
(1) Technique

2. Recognize and Report Age-Specific Normal and Abnormal Vital Signs

3. Examinations
a. Methods
(1) Auscultation
(2) Palpation
(3) Percussion
(4) Mensuration
(5) Manipulation
(6) Inspection
b. Body positions/draping
(1) Sims
(2) Fowlers
(3) Supine
(4) Knee-chest
(5) Prone
(6) Lithotomy
(7) Dorsal recumbent
c. Pediatric exam
(1) Growth chart
(a) Measurements
(i) Techniques
b. OB-GYN exam
(1) Pelvic exam/PAP smear
(2) Prenatal/postpartum exams

4. Procedures
a. Procedure explanation and patient instructions
b. Supplies, equipment, and techniques
(1) Eye irrigation
(2) Ear irrigation
(3) Dressing change
(4) Suture/staple removal
(5) Sterile procedures
(a) Surgical assisting
(b) Surgical tray prep
(c) Antiseptic skin prep
(d) Sterile field boundaries
(e) Surgical instruments
(i) Classifications
(ii) Instrument use

5. Patient Education/Health Coach
a. Health maintenance and disease prevention
(1) Diabetic teaching and home care
(a) Home blood sugar monitoring
(2) Instruct on use of patient mobility equipment and assistive devices
(3) Pre-/post-op care instructions
(4) Patient administered medications
(5) Home blood pressure monitoring and lifestyle controls
(6) Home anticoagulation monitoring
(7) Home cholesterol monitoring
b. Alternative medicine

6. Wellness/Preventive Care
a. Cancer screening
b. Sexually transmitted infections
c. Hygienic practices
(1) Hand washing
(2) Cough etiquette
d. Smoking risks and cessation
e. Recognition of substance abuse
f. Osteoporosis screening/bone density scan
g. Domestic violence screening and detection

R. Nutrition

1. Basic Principles
a. Food nutrients
(1) Carbohydrates
(2) Fats
(3) Proteins
(4) Minerals/electrolytes
(5) Vitamins
(6) Fiber
(7) Water
b. Dietary supplements

2. Special Dietary Needs
a. Weight control
b. Diabetes
c. Cardiovascular disease
d. Hypertension
e. Cancer
f. Lactose sensitivity/intolerance
g. Gluten free
h. Food allergies

3. Eating Disorders

S. Collecting and Processing Specimens

1. Methods of Collection
a. Blood
(1) Venipuncture
(a) Site selection
(b) Site prep
(c) Equipment
(i) Evacuated tubes
(ii) Tube additives
(iii) Needles
(2) Capillary/dermal puncture
b. Urine
(1) Random
(2) Midstream/clean catch
(3) Timed 24-hour collection
(4) Catheterization
(5) Pediatric urine collector
c. Fecal specimen
d. Sputum specimen
e. Swabs
(1) Throat
(2) Genital
(3) Wound
(4) Nasopharyngeal

2. Prepare, Process, and Examine Specimens
a. Proper labeling
b. Sources of contamination
c. Specimen preservation
(1) Refrigeration
(2) Fixative
d. Recordkeeping
e. Incubator
f. Centrifuge
g. Microscope
h. Inoculating a culture
i. Microbiologic slides
(1) Wet mount

3. Laboratory Quality Control/Quality Assurance
a. Testing protocols
b. Testing records and performance logs
c. Daily equipment maintenance
d. Calibration
e. Daily control testing
f. Monitor temperature controls
g. Reagent storage
h. CLIA-waived tests

4. Laboratory Panels and Performing Selected Tests
a. Urinalysis
(1) Physical
(2) Chemical
(3) Microscopic
(4) Culture
b. Hematology panel
(1) Hematocrit
(2) Hemoglobin
(3) Erythrocyte sedimentation rate
(4) Automated cell counts
(a) Red blood cell (RBC)
(b) White blood cell (WBC)
(c) Platelet
(5) Coagulation testing/INR
c. Chemistry/metabolic testing
(1) Glucose
(2) Kidney function tests
(3) Liver function tests
(4) Lipid profile
(5) Hemoglobin A1c
d. Immunology
(1) Mononucleosis test
(2) Rapid Group A Streptococcus test
(3) C-reactive protein (CRP)
(4) HCG pregnancy test
(5) H. pylori
(6) Influenza
e. Fecal occult blood/guaiac testing

T. Diagnostic Testing

1. Cardiovascular Tests
a. Electrocardiography (EKG/ECG)
(1) Perform standard 12-lead
(2) Lead placement
(3) Patient prep
(4) Recognize artifacts
(5) Recognize rhythms, arrhythmias
(6) Rhythm strips
b. Holter monitors
c. Cardiac stress test

2. Vision Tests
a. Color
b. Acuity/distance
(1) Snellen
(2) E chart
(3) Jaeger card
c. Ocular pressure
d. Visual fields

3. Audiometric/Hearing Tests
a. Pure tone audiometry
b. Speech and word recognition
c. Tympanometry

4. Allergy Tests
a. Scratch test
b. Intradermal skin testing

5. Respiratory Tests
a. Pulmonary function tests (PFT)
b. Spirometry
c. Peak flow rate
d. Tuberculosis tests/purified protein derivative (PPD) skin tests

6. Distinguish Between Normal/Abnormal Laboratory and Diagnostic Test Results

U. Pharmacology

(For the 50 most commonly used medications, visit the AAMA website at http://www.aama-ntl.org/cma-aama-exam/study.)

1. Medications
a. Classes of drugs
b. Drug actions/desired effects
c. Adverse reactions
d. Physicians' Desk Reference (PDR)
e. Storage of drugs

2. Preparing and Administering Oral and Parenteral Medications
a. Dosage
(1) Metric conversion
(2) Units of measurements
(3) Calculations
b. Routes of administration
(1) Intramuscular
(a) Z-tract
(2) Subcutaneous
(3) Oral/sublingual/buccal
(4) Topical
(5) Inhalation
(6) Instillation (eye-ear-nose)
(7) Intradermal
(8) Transdermal
(9) Vaginal
(10) Rectal
c. Injection site
(1) Site selection
(2) Needle length and gauge
d. Medication packaging
(1) Multidose vials
(2) Ampules
(3) Unit dose
(4) Prefilled cartridge-needle units
(5) Powder for reconstitution
e. Six Rights of Medication Administration
(1) Right patient, right drug, right route, right time, right dose, right documentation

3. Prescriptions
a. E-prescribing
b. Controlled substance guidelines

4. Medication Recordkeeping
a. Reporting/documenting errors

5. Immunizations
a. Childhood
b. Adult
c. Recordkeeping
(1) Vaccine information statement (VIS)
d. Vaccine storage

V. Emergency Management/Basic First Aid

1. Assessment and Screening
a. Treatment algorithms/flow charts
b. Triage algorithms/flow charts

2. Identification and Response to Emergencies
a. Bleeding/pressure points
b. Burns
c. Cardiac and respiratory arrest
d. Foreign body obstruction
e. Choking
f. Diabetic ketoacidosis
g. Insulin shock
h. Bone fractures
i. Poisoning
j. Seizures
k. Shock
l. Cerebral vascular accident (CVA)
m. Syncope
n. Vertigo
o. Wounds
p. Cold exposure
q. Heat exposure
r. Joint dislocations/sprains/strains
s. Asthmatic attack
t. Hyperventilation
u. Animal bite
v. Insect bite
w. Concussion

3. Office Emergency Readiness
a. Equipment
(1) Crash cart supplies
(2) Automated external defibrillator
b. Emergency response plan
(1) Evacuation plan

Content Outline for the CMA (AAMA)® Certification Exam (effective on and after 7/15/21)

Content Outline for the CMA (AAMA)® Certification Exam

I. A–D Clinical Competency

A. Clinical Workflow: Patient Intake and Discharge

1. Vital Signs
a. Blood pressure principles and technique
b. Pulse points and techniques
(1) Rate and rhythm
c. Height/Weight/BMI
d. Body temperature techniques and equipment
e. Pulse oximetry
f. Respiration rate and pattern
g. Pain scale
h. Pediatric measurements/Growth chart
i. Recognize/Document/Report age-specific normal and abnormal vital signs

2. Medical Terminology
a. Word parts (roots, combining forms, prefixes, suffixes)
b. Diagnostic procedures
c. Surgical procedures

3. Interviewing Techniques
a. Obtain concise and accurate reporting of relevant information
b. Open-ended/Exploratory questions
c. Closed/Direct questions

4. Documentation of Care
a. Chief complaint
b. Subjective data/Present illness
c. Review of systems
d. Past medical history
e. Reconciliation of medications and/or allergies
f. Family history
g. Social and occupational history
h. Objective data/Examination
i. Treatment/Compliance
j. Making addendums/corrections

5. Patient Screenings/Wellness Assessments
a. Cancer prevention and screening
b. Prevention/Screening of sexually transmitted infections
c. Nicotine risks and cessation
d. Recognition of substance use/addiction
e. Osteoporosis screening
f. Domestic violence screening and detection
g. Suicide awareness and response
h. Depression screening

6. Processing Provider Orders
a. Diabetic teaching
b. Instructions on use of mobil­ity equipment and assistive devices (e.g., crutches, cane, walker, wheelchair)
c. Pre-/Post procedure/treatment instructions
d. Patient-administered treatments and medications (e.g., self-injections, nebulizers)
e. Home monitoring (e.g., blood pres­sure, anticoagulation, blood sugar)
f. Alternative medicine/Massage/Acupuncture
g. Nutrition counseling
(1) Basic nutritional elements
(a) Carbohydrates
(b) Fats
(c) Proteins and amino acids
(d) Minerals and electrolytes
(e) Vitamins
(f) Fiber
(g) Water
(2) Function of dietary supplements and herbs
(3) Special dietary needs
(a) Weight control
(b) Diabetes
(c) Cardiovascular disease/Hypertension
(d) Cancer
(e) Food sensitivity/intolerance (e.g., lactose, gluten, nut)
(f) Kidney disease
(4) Food label interpretation
(5) Eating disorders

B. Safety and Infection Control

1. Infectious Agents
a. Bacteria
b. Viruses
c. Protozoa/Parasites
d. Fungi/Yeast

2. Infection Cycle/Chain of Infection
a. Body’s natural barriers

3. Modes of Infectious Transmission
a. Direct
b. Indirect

4. Standard Precautions and Exposure Control
a. Occupational Safety and Health Administration (OSHA)
b. Personal protective equipment
c. Hand hygiene (handwashing, alcohol-based gel)
d. Post-exposure protocol/Eyewash station
e. Sharps/Needle safety

5. Medical Asepsis
a. Sanitization
b. Disinfection
c. Cleaning (equipment, examination room, procedure area, business office, reception/scheduling areas)

6. Biohazard Disposal/Regulated Waste
a. Blood/Body fluids/Body tissue disposal
b. Spill kit (when and how to use)

7. Safety Resources
a. Safety signs, symbols, labels
b. Safety data sheets (SDS)/Globally Harmonized System of Classification and Labeling Chemicals (GHS)

8. Safety and Emergency Procedures
a. Workplace safety/Emergency preparedness/Evacuation
b. Crash cart supplies/equipment
c. Fire prevention/regulations/extinguisher

9. Emergency Management, Identification, and Response/ Basic First Aid
a. Bleeding control
b. Burns
c. Cardiac/Respiratory arrest
d. Foreign body obstruction
e. Diabetic ketoacidosis
f. Insulin shock
g. Bone fractures
h. Poisoning
i. Seizures
j. Shock
k. Cerebrovascular accident (CVA)
l. Syncope
m. Lacerations/Avulsions/Punctures/Abrasions
n. Cold/Heat exposure
o. Joint dislocations/Sprains/Strains
p. Asthmatic attack
q. Hyperventilation
r. Animal/Insect bite
s. Head trauma
t. Chemical exposure

10. Body Mechanics/Ergonomics

11. Risk Management, Quality Assurance, and Safety Procedures
a. Reporting unsafe or unlawful activities and behaviors
b. Conflicts of interest
c. Incident reporting/Patient safety variance reporting

C. Procedures/Examinations

1. Prepare Patients for Examinations, Procedures, and Treatments
a. Examination Methods
(1) Auscultation
(2) Inspection
(3) Mensuration
(4) Palpation
(5) Percussion
b. Body positioning
(1) Dorsal recumbent
(2) Fowler’s
(3) Knee-chest
(4) Lithotomy
(5) Prone
(6) Sims
(7) Supine
c. Pediatric examinations
d. Obstetric/Gynecologic examinations

2. Supplies, Equipment, Techniques, and Patient Instruction
a. Eye irrigation
b. Ear irrigation
c. Suture/Staple removal
d. Cast care/Splints/Slings

3. Surgical Assisting
a. Surgical asepsis
b. Surgical scrub
c. Surgical tray prep/Sterile field boundaries
d. Antiseptic skin prep

4. Wound Care
a. Chronic/Non-healing
b. Bandaging/Dressing change
c. Post-op incision care
d. Ostomy care

5. Instruments
a. Classifications
b. Identification
c. Use
d. Sterilization techniques/Autoclave
(1) Preparing items
(2) Wrapping items/Label/Date
(3) Sterilization indicators/Quality control measures

6. Anatomy and Physiology
a. Human growth and development
b. Normal developmental patterns/milestones across the life-span
c. Structural units (cell/tissue/organ)
d. Anatomical divisions, body cavities
e. Anatomical positions and directions
f. Body planes and quadrants
g. Body systems, NORMAL struc­ture and function

(1) Integumentary
(2) Musculoskeletal
(3) Nervous
(4) Cardiovascular, hematopoietic, and lymphatic
(5) Respiratory
(6) Digestive
(7) Urinary
(8) Reproductive
(9) Endocrine
(10) Sensory
h. Body systems, ABNORMAL structure and function, recognition and etiology
(1) Integumentary
(2) Musculoskeletal
(3) Nervous
(4) Cardiovascular, hematopoietic, and lymphatic
(5) Respiratory
(6) Digestive
(7) Urinary
(8) Reproductive
(9) Endocrine
(10) Sensory

7. Specimen Collection Techniques
a. Methods of collection
(1) Blood
(a) Venipuncture technique (site selection/patient prep)
(b) Equipment/Needles
(c) Tube additives
(d) Specimen preparation (serum/plasma/whole blood)
(e) Capillary/Dermal puncture (finger, heel, ear)
(2) Urine
(a) Random
(b) Midstream clean catch
(c) Timed (e.g., 24-hour) collection
(d) Catheterization
(e) Pediatric urine collection
(f) Drug screen/Chain of custody
(3) Fecal specimen
(4) Sputum specimen
(5) Swabs
(a) Throat
(b) Wound
(c) Nasopharyngeal

8. Prepare, Process, and Examine Specimens
a. Proper specimen labeling
b. Sources of specimen contami­nation
c. Specimen preservation
(1) Refrigeration
(2) Fixative
d. Centrifuge
e. Microscope
f. Wet mount (saline and KOH) slides

9. Laboratory Quality Control/Quality Assurance/Clinical Laboratory Improvement Act (CLIA) Requirements
a. Testing records and performance logs
b. Equipment calibration and main­tenance
c. Quality control testing
d. Monitor and document tempera­ture controls

10. Laboratory Panels and Selected Tests
a. Urinalysis
(1) Physical
(2) Chemical
(3) Microscopic
b. Hematology
(1) Hematocrit
(2) Hemoglobin
(3) Erythrocytic sedimentation rate (ESR)
(4) Automated cell counts
(a) Red blood cell (RBC)
(b) White blood cell (WBC)
(c) White cell differential
(d) Platelet
(5) Coagulation testing (INR)
c. Chemistry/Metabolic testing
(1) Glucose
(2) Kidney function
(3) Liver function
(4) Lipid profile
(5) Hemoglobin A1C
(6) Electrolytes
(7) Thyroid function
d. Specialized testing
(1) Mononucleosis
(2) Rapid Group A Streptococcus
(3) C-reactive protein (CRP)
(4) HCG (pregnancy test)
(5) H. pylori
(6) Influenza
(7) Genetic/Hereditary
(8) Tuberculosis tests/Purified protein derivative (PPD) skin test
(9) Cardiovascular
(a) Electrocardiography
(i) Perform standard 12-lead
(ii) Recognize and eliminate artifacts
(iii) Recognize rhythms, ar­rhythmias
(b) Holter/Event monitors
(c) Cardiac stress test
(10) Vision
(a) Color vision
(b) Visual acuity
(i) Near vision
(ii) Distance vision
(c) Ocular pressure/Tonometry
(d) Visual fields
(11) Audiometric/Hearing
(a) Pure tone audiometry
(b) Speech and word recognition
(c) Tympanometry
(12) Allergy
(a) Scratch test
(b) Intradermal skin test
(c) Patch test
(d) Radioallergosorbent test (RAST)
(13) Respiratory

(a) Pulmonary function tests (PFTs)
(b) Spirometry
(c) Peak flow rate
(14) Diagnostic imaging (e.g., MRI, CT scan, nuclear, ultrasound)
e. Differentiate between normal and abnormal laboratory and diagnostic test results

D. Pharmacology

(Visit “www.clincalc.com” for the 50 most commonly used medications.)

1. Medications
a. Classes of drugs
b. Drug actions/Desired effects/Indi­cations for use
c. Adverse reactions/Side effects/Allergic reactions
d. Contraindications
e. Storage of drugs/Inventory control

2. Preparing and Administering Oral and Parenteral Medications
a. Rights of medication administration
b. Dosage of medications
(1) Metric conversion
(2) Units of measure
(3) Calculations of medication dosage
c. Routes of administration includ­ing safety precautions
(1) Intramuscular
(a) Z-track
(2) Subcutaneous
(3) Oral/Sublingual/Buccal
(4) Topical/Transdermal
(5) Inhalation
(6) Instillation (eye, ear, nose)
(7) Intradermal
(8) Vaginal/Rectal
d. Injections
(1) Site selection
(2) Needle length and gauge
e. Medication documentation

(1) Documenting administration of medications
(2) Reporting medication errors

3. Immunization Resources
a. Centers for Disease Control and Prevention (CDC)
(1) Childhood/Adult immunizations
(2) Recordkeeping for immunizations
(3) Vaccine Information Statement (VIS)
(4) Vaccine Adverse Event Reporting System (VAERS)
(5) Vaccine storage

II. General

E. Legal and Ethical Issues

1. Health Insurance Portability and Accountability Act (HIPAA)
a. Maintain confidentiality/patient privacy (verbal and written)
b. Health Information Technology for Economic and Clinical Health Act (HITECH)
c. Patients’ right to inspect, amend, and restrict access to their medi­cal records
d. Patients’ Bill of Rights legislation/Patient Care Partnership
e. Security of electronic transmis­sion of information (encryption, password, firewall, activity log)

2. Protected Health Information (PHI)
a. Authorization to release
(1) Drug and alcohol treatment records
(2) HIV-related information
(3) Mental health records
(4) Genetic Information Nondiscrimina­tion Act of 2008 (GINA)
(5) Release for continuity of care
b. Authorization to rescind release
c. Use and disposal of PHI

3. Consent

a. Informed/Written
b. Implied/Verbal
c. Exceptions (e.g., mature or eman­cipated minor, dependent adult, emergency situations)

4. Federal and State Regulations
a. Professional Liability Torts
(1) Negligence
(2) Slander
(3) Libel
(4) Abandonment
(5) Assault
(6) Battery
b. Current standard of care
c. Legal terms and doctrines
(1) Subpoena/Subpoena duces tecum
(2) Deposition
(3) Respondeat superior
(4) Good Samaritan laws/acts
d. Contracts (physician-patient relationships)
(1) Legal obligations to the patient
(2) Termination of medical care
(a) Elements/Behaviors for with­drawal of care
(b) Patient notification/documentation

5. Pharmaceutical Laws
a. Prescriptions/e-Prescribing
b. Drug schedules
c. Controlled substances (use and abuse)

6. Mandatory Reporting/Public Health Statutes
a. Communicable diseases
b. Vital statistics
c. Abuse/Neglect/Exploitation of child, elder, partner
d. Wounds of violence

7. Ethical Standards (Behaviors, Decisions, and Reporting)

8. Medical Directives
a. Advance directives
b. Living will (Do Not Resuscitate [DNR] and Do Not Intubate [DNI])
c. Medical durable power of attorney
d. Patient Self Determination Act (PSDA)

F. Communication

1. Interpersonal Relationship Skills/Customer Service
a. Understanding human behavior and mental health
b. Defense mechanisms: recogni­tion and adaptive responses
c. Identify and adapt approach to communication barriers with em­pathy and compassion
(1) Death and dying/Terminal illness
(2) Visually/Hearing impaired/Interpreter
(3) Non-English speaking/English as a second language/Interpreter
(4) Americans with Disabilities Act Amendments Act (ADAAA) compliance
(5) Illiterate
(6) Intellectually challenged
(7) Age-specific therapeutic/adaptive responses
(a) Geriatric
(b) Pediatric/Adolescent
d. Non-verbal communication (e.g., posture, facial expression, eye contact, gestures, touch)
e. Personal boundaries (e.g., sexual harassment, bullying, unwanted attention)
f. De-escalation techniques
g. Listening skills
h. Service recovery/Patient satisfaction

2. Therapeutic/Adaptive Responses
a. Cultural diversity and beliefs
b. Recognize stereotypes and biases and display impartial conduct (race, religion, age, gender, etc.)

3. Learning Styles
a. Assessing and adapting to level of understanding (sender-receiver-feedback)
b. Identifying and overcoming barriers to communication (internal/external/environmental distractions)

4. Health Care Team Roles
a. Understanding/Communicating plan of care and referral coordination
b. Serving as patient navigator/advocate/case manager/health coach
c. Utilizing a team approach to patient care management
d. Identifying medical specialties

5. Professional Telephone Etiquette/Techniques
a. Message protocols
b. Screening/Gathering data

III. Administrative

G. Billing, Coding and Insurance

1. Coding Applications
a. Procedural coding (Current Procedural Terminology [CPT])
(1) Modifiers
(2) Upcoding/Downcoding
(3) Bundling/Unbundling of charges
b. Diagnostic coding (International Classification of Diseases, Clinical Modification [ICD-CM])
c. Healthcare Common Procedure Coding System (HCPCS Level II)
d. Linkage of procedure and diagnostic coding to meet medical necessity guidelines

2. Insurance Fraud and/or Abuse

3. Coverage for Patient Services and Waivers
a. Insurance eligibility verification
b. Insurance claims
(1) Submission
(2) Explanation of benefits (for patients)
(3) Remittance advice (for providers)
(4) Claim rejection and follow-up
(5) Tracking unpaid claims
c. Advance Beneficiary Notice (ABN)

4. Insurance Types/Third-Party Payers
a. Commercial plans
b. Medicare/Medicare Advantage Plans
c. Medicaid/State Children’s Health Insurance Program (SCHIP)
e. Managed care
f. Workers’ compensation

5. Authorizations and Resources
a. Precertification/Prior authorization
(1) Diagnostic and surgical procedures
(2) Medications/Drug formulary
b. Denials/Appeals

6. Financial Terminology
a. Accounts receivable
b. Accounts payable
c. Debits
d. Credits/Credit balance
e. Deductible

7. Patient Account Financial Procedures
a. Post charges
b. Post payments
c. Post adjustments/Write-offs
d. End-of-day reconciliation

8. Financial Calculations

9. Billing/Collections
a. Itemized statements
b. Aging of accounts
c. Collecting payments (e.g., co-pay, pre-pay, co-insurance, self-pay)
d. Preplanned payment options/credit arrangements
e. Use of collection agencies
f. Account collection rules

H. Scheduling Appointments and Health Information Management

1. Scheduling Appointments

a. New patient
b. Established patient
c. Routine versus urgent
d. Coordinate facility/equipment/personnel requirements
e. Ancillary services (laboratory, X-ray, surgery, outpatient procedures, hospital admissions)
f. Cancellations/No-shows/Physician delay or unavailability

2. Medical Reception/Patient Registration
a. Patient identification/Obtain patient demographics
b. Identity theft protection
c. Obtain accurate billing information

3. Electronic Health Records
a. Patient portal
b. Recognize/Identify/Organize medical reports
(1) History and physical
(2) Discharge summary
(3) Operative note
(4) Diagnostic test/Laboratory report
(5) Clinic progress note
(6) Consultation report
(7) Growth charts, graphs, tables
c. Medical record preparation/Pre-visit planning
(1) Obtain copy of patients’ outside medical record and/or pertinent test results