CPT Modifiers Quiz
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- 1.
- 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.
- 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.
- 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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