CPT Modifiers Quiz

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  • 1. 
    Increased procedural services
    • A. 

      24

    • B. 

      22

    • C. 

      25

    • D. 

      26


  • 2. 
    Anesthesia by surgeon
    • A. 

      25

    • B. 

      27

    • C. 

      52

    • D. 

      47


  • 3. 
    Staged or related procedure or service by the same physician during the postoperative period
    • A. 

      99

    • B. 

      52

    • C. 

      58

    • D. 

      62


  • 4. 
    Discontinued procedure
    • A. 

      53

    • B. 

      32

    • C. 

      66

    • D. 

      73


  • 5. 
    Discontinued outpatient hospital/ambulatory surgery center (ASC) procedure after administration of anesthesia
    • A. 

      47

    • B. 

      81

    • C. 

      74

    • D. 

      82


  • 6. 
    Unrelated procedure or service by the same physician during the postoperative period
    • A. 

      73

    • B. 

      79

    • C. 

      80

    • D. 

      60


  • 7. 
    Multiple modifiers
    • A. 

      99

    • B. 

      91

    • C. 

      62

    • D. 

      66


  • 8. 
    Modifiers -73 and -74 are most appropriate in:
    • A. 

      Inpatient Hospital only.

    • B. 

      Home Health.

    • C. 

      Outpatient Hospital and Ambulatory Surgery Centers (ASC)

    • D. 

      Emergency Room services.


  • 9. 
    What is the correct order of the following three modifiers:-54, -55, -56.
    • A. 

      Surgery care only, Post-Op, Pre-op`

    • B. 

      Pre-op, Surgery, Post-op.

    • C. 

      Pre-op, Post-op, Surgery.

    • D. 

      Decision for surgery, Pre-op, Post-op.


  • 10. 
    Distinct Procedural Services, modifier _____ is:
    • A. 

      59, Only used on surgical procedure codes.

    • B. 

      59, Only used to specify separate incision on an existing site.

    • C. 

      59, Only used surgeons are involved.

    • D. 

      None of the Above.


  • 11. 
    Modifier -62, _________ is used:
    • A. 

      Two surgeons, two are primary.

    • B. 

      Surgical team, one primary and one assistant surgeon.

    • C. 

      Repeat procedure by same physician, same procedure billed.

    • D. 

      Assistant surgeon, assistant is available for the entire operation.


  • 12. 
    The reason you used modifiers -76, -77 is to:
    • A. 

      Explain why the patient returned to the operating room during the post-operative period.

    • B. 

      Comply with CMS compliance guidelines.

    • C. 

      Only to supply information, reimbursement will not be affected.

    • D. 

      Explain why a procedure was duplicated, usually with a report, so you will be reimbursed appropriately.


  • 13. 
    When using modifier -80, assistant surgeon, the primary surgeon must use modifier:
    • A. 

      Modifier -81.

    • B. 

      Modifier -66.

    • C. 

      Modifier -62.

    • D. 

      No modifier is necessary for the primary surgeon.


  • 14. 
    The main difference between modifier -80 and modifier -81 is:
    • A. 

      The board certification of the assistant surgeon.

    • B. 

      Amount of time the assistant surgeon spends in the OR.

    • C. 

      -81 is used to indicate the primary surgeon and -80 is for the assistant.

    • D. 

      -80 is used for the primary surgeon, -81 for the assistant.


  • 15. 
    Billing mistakes because the appropriate aoutside reference laba modifier was not used, could:
    • A. 

      Be corrected if modifier -91 is used.

    • B. 

      Cause confusion but will not affect reimbursement.

    • C. 

      Trigger a Medicare audit for Medicare patients.

    • D. 

      Easily be corrected using modifier -92.


  • 16. 
    Modifier _______, Repeat Clinical Diagnostic Laboratory Test _________:
    • A. 

      -90, is used when there are testing problems with either the specimen or equipment.

    • B. 

      -91, is used only when it is necessary to obtain subsequent (multiple) reading of a test on the same day.

    • C. 

      -90, is used only the it is necessary to obtain subsequent (multiple) reading of a test on the same day.

    • D. 

      -91, is used when there are testing problems with either the specimen or equipment.


  • 17. 
    Evaluation and Management services were performed on an established patient in which the decision to perform a major surgery scheduled for the following morning was made. The patient was counseled for 15 minutes regarding treatment options, risks, and projected outcome. Which of the following modifiers would be appended to the service performed?
    • A. 

      -56

    • B. 

      -52

    • C. 

      -50

    • D. 

      -57


  • 18. 
    When a patient is in a postoperative period and returns to the operating room for an unrelated procedure by the same physician, which of the following modifiers would you attach to the procedure being performed?
    • A. 

      -59

    • B. 

      -24

    • C. 

      -78

    • D. 

      -79


  • 19. 
    When two surgeons work together as primary surgeons performing distinct part(s) of a single reportable procedure, each surgeon should report his/her distinct operative work by adding which of the following modifiers?
    • A. 

      -54

    • B. 

      -66

    • C. 

      -59

    • D. 

      -62


  • 20. 
    Which modifier is used to describe a CLIA waived test?
    • A. 

      QP

    • B. 

      QW

    • C. 

      GA

    • D. 

      SG


  • 21. 
    Which modifier indicates diagnostic mammogram converted from screening mammogram on the same day?
    • A. 

      -59

    • B. 

      -58

    • C. 

      -AT

    • D. 

      -GH


  • 22. 
    Anesthesia-related modifiers include:
    • A. 

      -23; -47.

    • B. 

      -58; -59.

    • C. 

      -32; -34.

    • D. 

      -90; -91.


  • 23. 
    The modifier -RT and -LT are:
    • A. 

      Right and Left.

    • B. 

      Never used with MOD-50.

    • C. 

      HCPCS modifiers.

    • D. 

      All of the above are correct.


  • 24. 
    Which group of modifier below, are most likely NOT to be recognized by insurance carriers?
    • A. 

      MOD-25, MOD-51 and MOD-82.

    • B. 

      MOD-63, MOD-53, MOD-54, MOD-55, MOD-56.

    • C. 

      MOD-26, MOD-50 and MOD-62

    • D. 

      Insurance companies are required by the AMA to recognize all valid CPT modifiers.


  • 25. 
    Modifiers -54 and -55 most likely would be used.
    • A. 

      Together, on the same claim.

    • B. 

      In primary care.

    • C. 

      By two different physicians, on separate claims.

    • D. 

      To indicate whether the operation was on the left or right side of the body.


  • 26. 
    Modifier -TC means:
    • A. 

      Terminal Case (patient is dying)

    • B. 

      Use this only for the Interpretation and Report.

    • C. 

      Technical Component.

    • D. 

      Time Code (This indicates the patient's heart stopped during the procedure)


  • 27. 
    You can / cannot use modifiers on HCPCS codes.
    • A. 

      You can.

    • B. 

      You cannot.

    • C. 

      You could before 2004 but no longer.

    • D. 

      You can but for local codes only.


  • 28. 
    Adding modifier ____, Unusual Services modifier, indicates "additional effort or time":
    • A. 

      -22; It is only used when the procedure takes LESS time or effort..

    • B. 

      -23; It will ensure that higher billing is warranted.

    • C. 

      -23; Will ensure higher billing, only when a report is included..

    • D. 

      -22; May still not be compensated at a higher rate, even with a report, if the carrier doesn't


  • 29. 
    The modifier -23, ____________ (would / would not) be appropriate for the use of a ________:
    • A. 

      Prolonged services; would; mid-wife.

    • B. 

      Professional Component; would not; microvascular surgeon..

    • C. 

      Unusual anesthesia, would not; accupuncture.

    • D. 

      Surgical assistant; would ; nurse anesthesist.


  • 30. 
    Modifier -24 should always be used with:
    • A. 

      Surgical CPT codes.

    • B. 

      E & M codes.

    • C. 

      Anesthesia CPT codes.

    • D. 

      Radiology codes.


  • 31. 
    Modifier -25 is:
    • A. 

      The unusual service modifier.

    • B. 

      Used for the initial evaluation of a problem for which a procedure is performed.

    • C. 

      Never used on E & M procedures.

    • D. 

      None of the above.


  • 32. 
    Under which of the following circumstances should coders report modifier -63?
    • A. 

      When a physician performs a procedure on an infant weighing 3.5 kg

    • B. 

      When a physician decides to perform surgery during an evaluation and management encounter

    • C. 

      When two surgeons work together to perform distinct parts of a surgery

    • D. 

      When a surgical assistant is present during a procedure


  • 33. 
    Which of the following modifiers should coders report to indicate that unusual anesthesia was necessary?
    • A. 

      -22

    • B. 

      -23

    • C. 

      -24

    • D. 

      -47


  • 34. 
    Which of the following does modifier -TA represent?
    • A. 

      Diagnostic mammogram converted from screen mammogram on same day

    • B. 

      Left hand, thumb

    • C. 

      Right foot, great toe

    • D. 

      Left foot, great toe


  • 35. 
    What anesthesia status modifier should coders report for a patient who has a severe systemic disease that is a constant threat to life?
    • A. 

      P1

    • B. 

      P2

    • C. 

      P4

    • D. 

      P6


  • 36. 
    What modifier should coders report when a physician elects to terminate a surgical or diagnostic procedure due to extenuating circumstances?
    • A. 

      -51

    • B. 

      -52

    • C. 

      -53

    • D. 

      -77


  • 37. 
    What modifier should coders report when a provider of services directly furnishes ambulance services?
    • A. 

      -GC

    • B. 

      -QN

    • C. 

      -QM

    • D. 

      -RC


  • 38. 
    What does modifier -E4 represent?
    • A. 

      Lower right, eyelid

    • B. 

      Upper left, eyelid

    • C. 

      Left hand, third digit

    • D. 

      Left hand, fourth digit Left hand, fourth digit Left hand, fourth digit Left hand, fourth digit


  • 39. 
    What modifier should coders report when a physician repeats a procedure or service that a different physician performed initially?
    • A. 

      -74

    • B. 

      -76

    • C. 

      -77

    • D. 

      -78


  • 40. 
    What modifier should coders report when there is an unusual circumstance that requires a physician to use general anesthesia for a procedure that, under normal circumstances, requires only local anesthesia or none at all?
    • A. 

      -22

    • B. 

      -23

    • C. 

      -47

    • D. 

      -50


  • 41. 
    Services mandated by an external agency not the responsibility of NHP
    • A. 

      -26

    • B. 

      -33

    • C. 

      -32

    • D. 

      47


  • 42. 
    Surgical or other invasive procedure on wrong body part
    • A. 

      PE

    • B. 

      PB

    • C. 

      PA

    • D. 

      PC


  • 43. 
    Repeat clinical laboratory diagnostic test
    • A. 

      -99

    • B. 

      -92

    • C. 

      -91

    • D. 

      -90


  • 44. 
    Staged or related procedure or service by same physician during post-op period
    • A. 

      -59

    • B. 

      -55

    • C. 

      -57

    • D. 

      -58


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