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5.05: CPC Exam: Medicine

Medicine is the most diverse section of the Current Procedural Terminology (CPT) manual. The Medicine section covers everything from vaccination to acupuncture, making it often very difficult to navigate.

There will only be around ten questions specifically related to Medicine on the CPC exam, meaning the AAPC has to condense a large and complicated section of the CPT manual into only a handful of questions.

Medicine takes up the 90281 – 99199 and 99500 – 99607 ranges of the CPT code manual, and makes up the final section of the manual before CPT Category II and Category III.

Individuals taking the exam should know the sections of the Medicine section and when to use which sections. For example, an injection of medication is not the same as a vaccination.

We bring up the issue of injection versus vaccination because it's leads us to another important element of the Medicine section: the Medicine section is one of the only places in the CPT manual where you'll find codes for a product (the substances that's being injected) instead of a service. Remember, the majority of the time we code for a product, we use HCPCS. In the Medicine section you'll find a few exceptions to that rule.

The Medicine section is made up of 33 different subsections, each pertaining to a different field of medicine.

As you can see, that's a lot of ground to cover. Since the Medicine section is so large and since, unlike Surgery, it covers so many different types of medical procedures, it's important to zero in on certain key terms while taking the exam.

A question may come out and say, explicitly, that the patient received dialysis for end-stage renal failure. If you spot the key term "dialysis," you'll know you're looking for a code in the 90935 to 90999 range.

Likewise, if a question describes a catheterization of the heart, you'll know to look either in the "Cardiovascular" subsection or the "Noninvasive vascular diagnostic studies." From there you can look at the question and ask: was surgery required to perform this catheterization? That is, was it invasive? If it wasn't, you can look for the code in the 93875 – 93990 ("Noninvasive vascular…) subsection. In questions involving Medicine, it's important to find as many landmarks as possible.

Like Anesthesia codes, many Medicine codes work as de facto Evaluation and Management codes. For example, if a patient comes in expressly to have an injection of a certain vaccine or medication, we wouldn't need to use an E&M code for that procedure. The evaluation portion before the injection would be covered in the Medicine code already.

Medicine is one of the trickiest sections to work with in the CPC exam. It helps to have a very strong base in medical terminology and anatomy and physiology.

Test-takers should take heart, however—in creating a test for such a broad, diverse topic as Medicine, the AAPC often errs on the side of broader, more general questions. Only rarely will you see a fine-grain question about Medicine on the CPC exam.

Video: CPC Exam: Medicine

This video is an overview on study tips for the diverse medicine portion of the Certified Professional Coder (CPC) exam.