Free CCMA flashcards

How do subcutaneous and intramuscular injections differ in needle angle and the tissue layer each one targets?

Route is defined by the target tissue. Subcutaneous delivery goes into adipose tissue at a shallower angle (45 or 90 degrees by build) for slower, sustained absorption from a less vascular layer. Intramuscular delivery uses 90 degrees so the needle reaches the more vascular muscle belly, which absorbs the drug faster.

Subcutaneous injections enter muscle at 45 degrees, while intramuscular injections enter the dermis at 90 degrees.

Tempting because both terms are listed and 45 and 90 degrees are correct angles in other contexts, but the target tissues are reversed. Subcutaneous targets fat under the dermis, not muscle, and intramuscular targets muscle, not the dermis.

When a prescription reads metoprolol 25 mg PO BID AC, how do you read the route, frequency, and timing together to instruct the patient?

Pharmacology abbreviations are read as a set: PO is the oral route, BID is twice daily, and AC means each dose is taken before a meal. So the faithful instruction is twice daily by mouth before meals.

PO BID AC means take the tablet twice a day shortly after the morning and evening meals.

Taking the dose after meals describes PC (post cibum), not AC. It is tempting if the abbreviations are confused, but it contradicts the written order, which specifies AC (before meals).

Before a patient leaves after a cardiology referral requiring pre-authorisation, what must the referring practice do?

Submit the pre-authorisation request to the insurer with the diagnosis code, the requested CPT code, and supporting clinical notes. Schedule the cardiology appointment only after written approval is received. Submitting before the service protects the patient from a denied claim and supports continuity of care.

The patient is the policy holder, so they should ring the insurer themselves to obtain pre-authorisation before a specialist appointment.

Offloading pre-authorisation to the patient is outside the accepted referral workflow. The referring practice is responsible for initiating the authorisation, not the patient. Leaving it to the patient routinely leads to denied claims and missed appointments.

You find a progress note misfiled into the wrong patient's paper chart. What is the correct filing-error procedure?

Relocate the misfiled note to the correct patient's chart and enter a brief correction note in both charts. Paper records are the legal account of care and must reside in the correct chart so providers act on accurate history, while the correction note gives auditors a clear trail of how and when the error was found and resolved.

Just cross out the misfiled note with a single line, write the correct patient name beside it, and leave it in the current chart.

Tempting because single-line strike-throughs are valid for error corrections, but crossing out and rewriting the patient name alters another patient's record, breaks chart integrity rules, and leaves the document in the wrong file where it can still be relied on for care decisions.