CPT Modifiers Quiz

44 Questions
CPT Quizzes & Trivia
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Questions and Answers
  • 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