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Mrs. Roberts falls at work. She claims that she is all right, but her employer's workers' compensation policy requires that she see a physician to confirm she was not injured when she fell. The physician files a claim to the workers' compensation carrier. Which modifier would you use when reporting the physician's service to the patient? ____________________

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Modifier -57, decision for surgery, is used on what type of service?


A) E/M
B) surgery
C) anesthesia
D) all of the above

E) A) and B)
F) A) and C)

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Modifier -52, reduced services, is used to indicate:


A) a service was discontinued
B) changes to the description of the code
C) a service was reduced without changing the definition of the code
D) the procedure was terminated at the request of the patient

E) B) and C)
F) A) and C)

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The modifier that indicates only the professional component of the service was provided is:


A) -50
B) -51
C) -22
D) -26

E) A) and C)
F) A) and B)

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____________________ lists some HCPCS modifiers in the CPT book.

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Appendix A...

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Modifiers may affect:


A) health care premiums
B) type of treatment provided
C) the way payment is made by a third-party payer
D) code selection

E) All of the above
F) A) and B)

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Mrs. Smith presented to her physician's office for an office visit for an upper respiratory infection. The physician examines the patient and prescribes antibiotics. The physician notices the patient has a suspicious-looking mole. The physician examined the mole and determined that it should be removed. The mole was removed during the same office visit. The physician bills both an E/M code and a procedure code. Which modifier would you use on the E/M code? ____________________

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-25 25

Modifier -25, significant, separately identifiable E/M service by the same individual on the same day of the procedure or other service, is used to report an E/M service that was:


A) performed in a postoperative period
B) provided on the same day as a minor procedure performed by the same individual
C) provided on the same day as a major procedure
D) all of the above

E) B) and D)
F) B) and C)

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The modifier that indicates multiple procedures is:


A) -32
B) -51
C) -22
D) -26

E) A) and B)
F) B) and C)

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B

Modifier -32 is used to indicate a service is mandated. Which of the following is an example of when a service is "mandated?"


A) Another physician requests a second opinion.
B) An insurance company requires a second opinion prior to surgery.
C) The patient requests a second opinion.
D) All of the above.

E) None of the above
F) A) and B)

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What modifier would you use if you were coding only the technical component of a diagnostic procedure? ____________________

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Modifier -79, unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period, is used on what type of service?


A) E/M
B) surgery
C) anesthesia
D) all of the above

E) None of the above
F) B) and C)

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Modifier ______ is used to indicate that services of an outside laboratory were used.

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Multiple modifiers are indicated with which modifier?


A) -47
B) -50
C) -22
D) -99

E) B) and D)
F) A) and C)

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The modifier "-AA" is an example of what type of modifier?


A) CPT
B) HCPCS
C) ICD-10-CM
D) None of the above

E) B) and C)
F) A) and C)

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B

Modifier -58, staged or related procedure or service by the same physician during the postoperative period, is used to indicate:


A) a patient is taken back to the operating room for surgical treatment of a complication resulting from a previous surgery
B) services provided usually bundled into one payment were provided as separate services
C) a service was repeated
D) a subsequent surgery was planned at the time of the first surgery

E) A) and B)
F) A) and C)

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Modifiers are used to indicate what type of information?


A) bilateral procedure
B) multiple procedures
C) service greater than usually required
D) all of the above

E) A) and C)
F) A) and D)

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Modifier -59, distinct procedure service, is used to indicate that:


A) services that are usually bundled into one payment were provided as separate services
B) a subsequent surgery was planned or staged
C) a service was repeated
D) a patient is taken back to the operating room for surgical treatment of a complication resulting from a previous surgery

E) B) and C)
F) C) and D)

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Modifier -51, Multiple Procedure, is used on what type of services?


A) E/M
B) surgery
C) anesthesia
D) all of the above

E) B) and D)
F) C) and D)

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Mr. Coslett has multiple surgeries performed during the same operative session. Which modifier would you use? ____________________

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