Copy of Modifier CEU Test

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CEU-Modifier3

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Question 1

Which statement is NOT true of modifiers?

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A) Modify the code description and change the core meaning

B) Provide additional information regarding the service provided

C) Tells the "story" more clearly

D) Integral part of CPT and the HCPCS coding system

Type: Multiple choiceCategory: CEU-ModifierPoints: 1Randomize answers: No

Feedback"Modify the code description and change the core meaning" is the correct answer because the coremeaning of the CPT code description does not change with the application of a modifier.

Feedback"Modify the code description and change the core meaning" is the correct answer because the coremeaning of the CPT code description does not change with the application of a modifier.

Question 2

Which modifier may result in an increase in revenue?


A) 54

B) 26

C) 22

D) 80


FeedbackModifier 22 - Increased Procedural Services states "When the work required to provide a service issubstantially greater than typically required, it may be identified by adding modifier 22 to the usualprocedure code. Documentation must support the substantial additional work and the reason for theadditional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient'scondition, physical and mental effort required). Note: This modifier should not be appended to an E/Mservice". Due to "substantially greater" work it is the modifier that is used when the expectation is that"substantially greater work" will mean an increase in reimbursement.

FeedbackModifier 22 - Increased Procedural Services states "When the work required to provide a service issubstantially greater than typically required, it may be identified by adding modifier 22 to the usualprocedure code. Documentation must support the substantial additional work and the reason for theadditional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient'scondition, physical and mental effort required). Note: This modifier should not be appended to an E/Mservice". Due to "substantially greater" work it is the modifier that is used when the expectation is that"substantially greater work" will mean an increase in reimbursement.

Question 3

Which modifier is considered a global package modifier?




A) 76

B) 26

C) 62

D) 50

Type: Multiple choice

Category: CEU-Modifier

Points: 1

Randomize answers: No

FeedbackModifier 76 Repeat Procedure or Service by Same Physician states "It may be necessary to indicate

that a procedure or service was repeated subsequent to the original procedure or service. This

circumstance may be reported by adding modifier 76 to the repeated procedure or service."

Modifier 26 Professional Component states "Certain procedures are a combination of a physician

component and a technical component. When the physician component is reported separately, the

service may be identified by adding modifier 26 to the usual procedure number."

Modifier 62 Two Surgeons states "When two surgeons work together as primary surgeons performing

distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding

modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both

surgeons continue to work together as primary surgeons. Each surgeon should report the co-surgery

once using the same procedure code. If additional procedure(s) (including add-on procedure(s) are

performed during the same surgical session, separate code(s) may also be reported with modifier 62

added. Note: If a co-surgeon acts as an assistant in the performance of additional procedure(s) during

the same surgical session, those services may be reported using separate procedure code(s) with

modifier 80 or modifier 82 added, as appropriate."

Modifier 50 Bilateral Procedure states "Unless otherwise identified in the listings, bilateral procedures

that are performed at the same operative session, should be identified by adding modifier 50 to the

appropriate five digit code."

The only modifier that would apply if you were in a global period out be modifier 76. After the first

procedure is reported the next time it had to be reported would necessitate modifier 76 be applied to

allow it to get through to be considered for payment.

FeedbackModifier 76 Repeat Procedure or Service by Same Physician states "It may be necessary to indicate

that a procedure or service was repeated subsequent to the original procedure or service. This

circumstance may be reported by adding modifier 76 to the repeated procedure or service."

Modifier 26 Professional Component states "Certain procedures are a combination of a physician

component and a technical component. When the physician component is reported separately, the

service may be identified by adding modifier 26 to the usual procedure number."

Modifier 62 Two Surgeons states "When two surgeons work together as primary surgeons performing

distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding

modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both

surgeons continue to work together as primary surgeons. Each surgeon should report the co-surgery

once using the same procedure code. If additional procedure(s) (including add-on procedure(s) are

performed during the same surgical session, separate code(s) may also be reported with modifier 62

added. Note: If a co-surgeon acts as an assistant in the performance of additional procedure(s) during

the same surgical session, those services may be reported using separate procedure code(s) with

modifier 80 or modifier 82 added, as appropriate."

Modifier 50 Bilateral Procedure states "Unless otherwise identified in the listings, bilateral procedures

that are performed at the same operative session, should be identified by adding modifier 50 to the

appropriate five digit code."

The only modifier that would apply if you were in a global period out be modifier 76. After the first

procedure is reported the next time it had to be reported would necessitate modifier 76 be applied to

allow it to get through to be considered for payment.

Question 4

Which level of HCPCS modifiers no longer exist?




A) HCPCS Level I

B) HCPCS Level II

C) HCPCS Level III

D) AMA CPT Manual Appendix A Modifiers


FeedbackHCPCS Level III used to be used by local carriers but was discontinued.

FeedbackHCPCS Level III used to be used by local carriers but was discontinued.

Question 5

Which of the following is NOT a helpful tip when using modifiers.


A) Know your payer and the settings they prefer.

B) Do not trust the payer to increase your fee for you.

C) Put modifiers that bundle first if appropriate.

D) Trust the payer to know you have charged the reduced amount.


FeedbackThe payer does not know that you have charged a reduced amount. The only information they have iswhat you submit. It is best to never make assumptions when money is involved.

FeedbackThe payer does not know that you have charged a reduced amount. The only information they have iswhat you submit. It is best to never make assumptions when money is involved.

Question 6

Mrs. Jones was seen in my office today and we made a decision for surgery but she willreturn next week for the pre-op visit. Which modifier would you use to inform the payer thisvisit is NOT a part of the global package?


A) 25

B) 57

C) 24

D) 56


FeedbackModifier -57 is decision for surgery. E/M service resulting in the decision to perform the surgery on theday before major surgery or on the day of major surgery (90 day post-op) is not included in the globalsurgery payment and is separately billable.



surgery payment and is separately billable.

FeedbackModifier -57 is decision for surgery. E/M service resulting in the decision to perform the surgery on theday before major surgery or on the day of major surgery (90 day post-op) is not included in the globalsurgery payment and is separately billable.

Question 7

Mr. White returns to my office today for removal of his sutures following his openappendectomy. Which modifier would you use to inform the payor this was a stagedprocedure?


A) 78

B) 77

C) 76

D) 62


FeedbackModifier -76, Repeat procedure by Same Physician shows the payer that, "I know this is the same CPTcode as above (or reported earlier) but it is a repeat not a duplicate."

FeedbackModifier -76, Repeat procedure by Same Physician shows the payer that, "I know this is the same CPTcode as above (or reported earlier) but it is a repeat not a duplicate."

Question 8

Which modifier would you use for an abdominal ultrasound performed on Mr. Blue after hisappendectomy to rule out gall stones.


A) 76

B) 78

C) 77

D) 79


FeedbackModifier -79, Unrelated Procedure or Service by the Same Physician During the Postoperative Period.Without this modifier the payer's computer system would kick it out as being part of the follow up periodfor the previous surgery.

FeedbackModifier -79, Unrelated Procedure or Service by the Same Physician During the Postoperative Period.Without this modifier the payer's computer system would kick it out as being part of the follow up periodfor the previous surgery.



Question 9

Which of the following codes and modifier pair violate CPT guidelines?


A) 78451-26

B) 68520-RT

C) 20985-51

D) 00120-P1

Type: Multiple choiceCategory: PBC MidtermPoints: 1Randomize answers: No

Question 10

It may be necessary to indicate that a procedure or service was repeated by the samephysician or other qualified health care professional subsequent to the original procedure orservice. This circumstance may be reported by adding what modifier?


A) 79

B) 78

C) 77

D) 76

Type: Multiple choiceCategory: PBC MidtermPoints: 1Randomize answers: No

Question 11

CPT codes 22840-22848 are modifier 62 exempt?


A) True

B) False

Type: True/FalseCategory: 2012CPCExamPoints: 1

FeedbackJust prior to code 22840 there are some code specific coding guidelines. In the third paragraph itstates, "do not append modifier 62 to spinal instrumentation codes 22840-22848 and 22850-20938".

FeedbackJust prior to code 22840 there are some code specific coding guidelines. In the third paragraph itstates, "do not append modifier 62 to spinal instrumentation codes 22840-22848 and 22850-20938".

Question 12



Which of the following codes allows the use of modifier 51?


A) 20975

B) 93600

C) 31500

D) 45392


Category: 2012CPCExam

Points: 1


FeedbackAppendix E lists all CPT codes that are modifier 51 exempt. Also beside each code in the tabular there

is a convention that looks like a circle with a backslash through it. This convention means that the

code next to it is modifier 51 exempt. Code 45392 is the only code not listed in appendix E and that

does not have this convention beside it.

FeedbackAppendix E lists all CPT codes that are modifier 51 exempt. Also beside each code in the tabular there

is a convention that looks like a circle with a backslash through it. This convention means that the

code next to it is modifier 51 exempt. Code 45392 is the only code not listed in appendix E and that

does not have this convention beside it.

Question 13

What modifier is appropriate for a separately billable antenatal service during the global OB

package period?


A) 24

B) 25

C) 57

D) No modifier is needed


Category: PMCC12-13 Female

Points: 1


FeedbackRationale: An antenatal service is performed before the baby is delivered. According to the guidelinesin Maternity Care and Delivery section in the CPT® manual states: "Antepartum care includes the initial

and subsequent history, physical examinations, recording of weight, blood pressures, fetal heart tones,

routine chemical urinalysis, and monthly visits up to 28 weeks gestation, biweekly visits to 36 weeks

gestation, and weekly visits until delivery."

FeedbackRationale: An antenatal service is performed before the baby is delivered. According to the guidelinesin Maternity Care and Delivery section in the CPT® manual states: "Antepartum care includes the initial

and subsequent history, physical examinations, recording of weight, blood pressures, fetal heart tones,

routine chemical urinalysis, and monthly visits up to 28 weeks gestation, biweekly visits to 36 weeks

gestation, and weekly visits until delivery."

Question 14

A patient with uterine prolapse presents for laparoscopic hysterectomy and colpopexy. After

induction of general anesthesia the laparoscope is introduced into the abdomen with

separate placement of ports for visualization. The surgeons began to tie off the uterine artery

when the patient had a sudden drop in blood pressure and could not be stabilized. The

procedure was discontinued. No procedures were completed. What are the CPT® and



modifier code(s) for this service?


A) 58570-52, 57425-52

B) 58570-53, 57425-53

C) 58570-53

D) 58570-73


Category: PMCC12-13 Female

Points: 1


Feedback[b]Rationale:[/b] After general anesthesia was given and the surgery for the laparoscopic hysterectomyhad started, the patient's blood pressure dropped and could not be stabilized. Using the CPT® Index,

there are two ways to find the code for a laparoscopic hysterectomy. Start with

Hysterectomy/Laparoscopic/Total or see Laparoscopy/Hysterectomy/Total. Both indicate code range

58570-58573. Modifier 53 is the correct modifier to append because there was a threat to the well being

of the patient during the surgery. You do not code for the colpopexy (57425) because the colpopexy

surgery had not begun.

FeedbackRationale: After general anesthesia was given and the surgery for the laparoscopic hysterectomy hadstarted, the patient's blood pressure dropped and could not be stabilized. Using the CPT® Index, there

are two ways to find the code for a laparoscopic hysterectomy. Start with

Hysterectomy/Laparoscopic/Total or see Laparoscopy/Hysterectomy/Total. Both indicate code range

58570-58573. Modifier 53 is the correct modifier to append because there was a threat to the well being

of the patient during the surgery. You do not code for the colpopexy (57425) because the colpopexy

surgery had not begun.

Question 15

A 22-year-old patient who has severe medical problems is placed under general anesthesia

by an anesthetist for a service not usually requiring anesthesia. What modifier would be

appended to the service?


A) 22

B) 23

C) 47

D) 52


Category: PMCC12-16 Anesthesia

Points: 1


FeedbackRationale: Modifier 23 may be reported to describe a procedure not usually requiring anesthesia (eithernone or local) - but due to unusual circumstances general anesthesia is necessary.

FeedbackRationale: Modifier 23 may be reported to describe a procedure not usually requiring anesthesia (eithernone or local) - but due to unusual circumstances general anesthesia is necessary.

Question 16

42-year-old patient was undergoing anesthesia in an ASC and began having complications

prior to the administration of anesthesia. The surgeon immediately discontinued the planned

surgery. If the insurance company requires a reported modifier, what modifier best describes

the extenuating circumstances?




A) 53

B) 23

C) 73

D) 74


Category: PMCC12-16 Anesthesia

Points: 1


FeedbackRationale: Although not typically reported by physicians, insurance companies may require specificmodifiers. The modifier 73 best describes an anesthesia service discontinued prior to administration of

anesthesia in an ASC.

FeedbackRationale: Although not typically reported by physicians, insurance companies may require specificmodifiers. The modifier 73 best describes an anesthesia service discontinued prior to administration of

anesthesia in an ASC.

Question 17

A patient has a fine needle aspiration with the aspirant sent to cytopathology for examination.

Once the specimen is reviewed, it is found to be inadequate to perform the test. A new

specimen must be obtained which is then examined and returns a diagnosis. What modifier

is appropriate to indicate that two specimens were examined?


A) 76

B) 77

C) 91

D) no modifier


Category: PMCC12-18 Path and Lab

Points: 1


FeedbackRationale: The first test cannot be billed if there is not a sufficient specimen to perform theexamination.

FeedbackRationale: The first test cannot be billed if there is not a sufficient specimen to perform theexamination.

Question 18

What modifier is used to report an evaluation and management service mandated by a court

order?


A) 24

B) 32

C) 57

D) 62



Type: Multiple choiceCategory: PMCC12-19 EMPoints: 1Randomize answers: No

FeedbackRationale: Modifier 32 is used for services related to mandated consultation and/or related services bya third party payer, governmental, legislative, or regulatory requirements.

FeedbackRationale: Modifier 32 is used for services related to mandated consultation and/or related services bya third party payer, governmental, legislative, or regulatory requirements.

Question 19

What modifier would be used to report the termination of a surgery following induction ofanesthesia due to extenuating circumstances or those that threaten the well being of thepatient?


A) Modifier 52

B) Modifier 22

C) Modifier 53

D) Modifier 54

Type: Multiple choiceCategory: PMCC12-06 Intro to CPTPoints: 1Randomize answers: No

FeedbackRationale: Modifier 53 is used to indicate the physician has elected to terminate a surgical ordiagnostic procedure due to extenuating circumstances or those that threaten the well being of thepatient. CPT® modifiers are found on the inside front cover and in Appendix A of your CPT® codebook.

FeedbackRationale: Modifier 53 is used to indicate the physician has elected to terminate a surgical ordiagnostic procedure due to extenuating circumstances or those that threaten the well being of thepatient. CPT® modifiers are found on the inside front cover and in Appendix A of your CPT® codebook.

Question 20

What is the appropriate modifier to use when two surgeons perform separate distinctportions of the same procedure?


A) 66

B) 80

C) 62

D) 59

Type: Multiple choiceCategory: PMCC12-06 Intro to CPTPoints: 1Randomize answers: No

FeedbackRationale: Modifier 62 is used when two surgeons work together as primary surgeons performingdistinct part(s) of a procedure. Modifiers and their descriptions can be found on the inside front coverand Appendix A of your CPT® codebook.



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Feedback

Rationale: Modifier 62 is used when two surgeons work together as primary surgeons performingdistinct part(s) of a procedure. Modifiers and their descriptions can be found on the inside front coverand Appendix A of your CPT® codebook.

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