Deck 21: CPT and Hcpcs Level Ii Modifiers
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Deck 21: CPT and Hcpcs Level Ii Modifiers
1
Which of the following codes shows properly sequenced modifiers?
A) 67700-RT-50
B) 24201-LT-76
C) 24201-76-LT
D) 67810-LT-50
A) 67700-RT-50
B) 24201-LT-76
C) 24201-76-LT
D) 67810-LT-50
C
2
What is the physical status modifier for a brain-dead patient?
A) P2
B) P6
C) P1
D) P5
A) P2
B) P6
C) P1
D) P5
B
3
What do personnel modifiers explain?
A) They indicate a service or procedure was performed by more than one physician.
B) They are an indicator of the level of complexity of services required to treat that patient.
C) They explain special circumstances relating to the health care professionals involved in the treatment of the patient.
D) They indicate that a service or procedure was not performed in total.
A) They indicate a service or procedure was performed by more than one physician.
B) They are an indicator of the level of complexity of services required to treat that patient.
C) They explain special circumstances relating to the health care professionals involved in the treatment of the patient.
D) They indicate that a service or procedure was not performed in total.
C
4
What does the physical status modifier describe?
A) The condition of the patient at the time anesthesia is administered.
B) The patient had a complication and had to return to the operating room.
C) The patient had a procedure performed on both sides of the body.
D) The patient had more than one surgeon operating on him or her.
A) The condition of the patient at the time anesthesia is administered.
B) The patient had a complication and had to return to the operating room.
C) The patient had a procedure performed on both sides of the body.
D) The patient had more than one surgeon operating on him or her.
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5
A patient had a biopsy performed on both of her breasts. What modifier would be appended to the CPT code?
A) 51
B) 50
C) 62
D) 59
A) 51
B) 50
C) 62
D) 59
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6
How many characters are in a HCPCS Level II Modifier?
A) Two characters: letters or numbers
B) Three letters
C) Three characters: letters or numbers
D) Two numbers
A) Two characters: letters or numbers
B) Three letters
C) Three characters: letters or numbers
D) Two numbers
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7
Modifier 66 is an example of a/an:
A) physical status modifier.
B) personnel modifier.
C) ambulatory surgery center modifier.
D) HCPCS Level II modifier.
A) physical status modifier.
B) personnel modifier.
C) ambulatory surgery center modifier.
D) HCPCS Level II modifier.
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8
A patient had a kidney transplant performed and a surgical team was needed. What modifier would be appended to the surgery code?
A) 80
B) 81
C) 82
D) 66
A) 80
B) 81
C) 82
D) 66
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9
Which modifier is used to identify a staged or related procedure?
A) 25
B) 58
C) 23
D) 59
A) 25
B) 58
C) 23
D) 59
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10
When is a physical status modifier used?
A) To indicate the level of complexity of services required to anesthetize that patient
B) To indicate a service or procedure was performed by more than one physician
C) To indicate a bilateral procedure was performed
D) To indicate that a service or procedure was not performed in total
A) To indicate the level of complexity of services required to anesthetize that patient
B) To indicate a service or procedure was performed by more than one physician
C) To indicate a bilateral procedure was performed
D) To indicate that a service or procedure was not performed in total
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11
There are some modifiers only used for:
A) surgery codes.
B) physical therapy codes.
C) pathology codes.
D) ambulatory surgery center codes.
A) surgery codes.
B) physical therapy codes.
C) pathology codes.
D) ambulatory surgery center codes.
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12
What are modifiers used for?
A) Presenting additional information pertinent to a procedure or service
B) Coding surgical procedures
C) Coding diagnosis
D) Presenting additional information pertinent to a diagnosis
A) Presenting additional information pertinent to a procedure or service
B) Coding surgical procedures
C) Coding diagnosis
D) Presenting additional information pertinent to a diagnosis
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13
What modifier is used to indicate when both a diagnostic and a screening mammogram are done on the same day on the same patient for performance and payment?
A) QM
B) LC
C) GG
D) LM
A) QM
B) LC
C) GG
D) LM
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14
The patient had a surgical procedure performed on the upper right eyelid. What modifier would be appended to the CPT code?
A) E1
B) E2
C) E3
D) E4
A) E1
B) E2
C) E3
D) E4
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15
P3 is an example of a/an:
A) surgical team modifier.
B) physical status modifier.
C) ambulatory surgery center modifier.
D) multiple procedure modifier.
A) surgical team modifier.
B) physical status modifier.
C) ambulatory surgery center modifier.
D) multiple procedure modifier.
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16
Where are the modifiers listed in the CPT book?
A) Alphabetic Index
B) Appendix A
C) Contents
D) Back page
A) Alphabetic Index
B) Appendix A
C) Contents
D) Back page
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17
The patient was taken to the procedure room at the ASC for a proctectomy, and the surgery was canceled after the administration of anesthesia. What modifier is appended to the CPT code?
A) 73
B) 74
C) 76
D) 77
A) 73
B) 74
C) 76
D) 77
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18
All modifiers consist of:
A) three numbers.
B) three letters.
C) two characters.
D) two letters.
A) three numbers.
B) three letters.
C) two characters.
D) two letters.
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19
A patient had a left knee total knee arthroplasty done. What modifier should be appended to the CPT code?
A) F3
B) T3
C) LT
D) LC
A) F3
B) T3
C) LT
D) LC
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20
Supplemental reports are required when which modifier is used?
A) 22
B) 50
C) 57
D) 26
A) 22
B) 50
C) 57
D) 26
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21
Dr. Oppenheim began the appendectomy on Mrs. Quinones when she began to bleed uncontrollably. He was able to stop the bleeding but decided to stop the procedure for the safety of the patient. What modifier is used?
A) 52
B) 53
C) 58
D) 59
A) 52
B) 53
C) 58
D) 59
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22
Both Dr. Carter and Dr. Minton operate on Mrs. Smith. Explain this with modifier:
A) 56.
B) 62.
C) 50.
D) 77.
A) 56.
B) 62.
C) 50.
D) 77.
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23
Dr. Files removed a cyst from Jane's left thumb. Indicate this with modifier:
A) F5.
B) F1.
C) FA.
D) FB.
A) F5.
B) F1.
C) FA.
D) FB.
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24
Dr. Perez operated on Erin's upper right eyelid. What modifier is used?
A) E1
B) E2
C) E3
D) E4
A) E1
B) E2
C) E3
D) E4
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25
Modifier P1 can be appended to only a(n):
A) evaluation and management code.
B) anesthesia code.
C) surgery code.
D) radiology code.
A) evaluation and management code.
B) anesthesia code.
C) surgery code.
D) radiology code.
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26
Using correct modifiers can:
A) promote efficient reimbursement for the facility.
B) cause the claim to be rejected.
C) identify causes of the patient's condition.
D) decrease reimbursement for the facility.
A) promote efficient reimbursement for the facility.
B) cause the claim to be rejected.
C) identify causes of the patient's condition.
D) decrease reimbursement for the facility.
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27
When an arthroscopy is done on both knees, append modifier:
A) 25.
B) 22.
C) 50.
D) 51.
A) 25.
B) 22.
C) 50.
D) 51.
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28
A patient had a left heart catheterization and a drug-eluting stent was placed in the left anterior descending coronary artery. What modifier is appended to the CPT code?
A) LC
B) LM
C) LD
D) LT
A) LC
B) LM
C) LD
D) LT
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29
Anesthesia is administered to a normal healthy person. Append modifier:
A) P1.
B) P2.
C) P3.
D) P4.
A) P1.
B) P2.
C) P3.
D) P4.
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30
Dr. Langer's coder is submitting the claim form for his role on the surgical team performing a heart transplant. What modifier will be used?
A) 62
B) 99
C) 66
D) 77
A) 62
B) 99
C) 66
D) 77
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31
Rebecca is scheduled for a carpal tunnel release at the ASC. However, as the nurse is preparing her for the surgery, it is noticed that Rebecca has a fever, and they cancel the procedure prior to any sedation. Report this with modifier:
A) 52.
B) 53.
C) 73.
D) 74.
A) 52.
B) 53.
C) 73.
D) 74.
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32
Dr. Farber provided only surgical care for James. Report this with modifier:
A) 54.
B) 55.
C) 56.
D) 58.
A) 54.
B) 55.
C) 56.
D) 58.
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33
A radiologist reviews and interprets a patient's x-ray and writes a report on the findings. What is the appropriate modifier?
A) 59
B) 74
C) TC
D) 26
A) 59
B) 74
C) TC
D) 26
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34
GH is an example of what kind of modifier?
A) CPT
B) ASC
C) HCPCS Level II
D) None of these
A) CPT
B) ASC
C) HCPCS Level II
D) None of these
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35
Modifiers are used to explain special circumstances relating to
A) the laterality of service.
B) the personnel providing service.
C) the physical status of the patient.
D) All of these
A) the laterality of service.
B) the personnel providing service.
C) the physical status of the patient.
D) All of these
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36
During his encounter, Warren agrees for Dr. Dyan to schedule his cataract surgery. Report this with modifier:
A) 56.
B) 24.
C) 54.
D) 57.
A) 56.
B) 24.
C) 54.
D) 57.
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37
When the surgeon administers the anesthesia and performs the procedure, use modifier:
A) 23.
B) 47.
C) 26.
D) 62.
A) 23.
B) 47.
C) 26.
D) 62.
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38
Due to an unusual circumstance, general anesthesia is administered for a procedure that normally uses no anesthesia at all. Report this with modifier:
A) 22.
B) 23.
C) 25.
D) 26.
A) 22.
B) 23.
C) 25.
D) 26.
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39
A surgical procedure is done on an infant weighing less than 4 kg. What modifier is used?
A) 62
B) 74
C) 63
D) 59
A) 62
B) 74
C) 63
D) 59
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40
Hartswell Insurance mandates Roger have a complete physical before a policy can be issued. Explain this with modifier:
A) 26.
B) 25.
C) 47.
D) 32.
A) 26.
B) 25.
C) 47.
D) 32.
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41
After he completed surgery on Dustin, Dr. Willis retired. Dr. Samson took over the postoperative care for Dustin. Which modifier should be reported for Dr. Samson?
A) 54
B) 55
C) 56
D) 57
A) 54
B) 55
C) 56
D) 57
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42
Dr. Walli operated on Jason's hammertoe on his left foot, fourth digit. Which modifier should be reported for his toe?
A) T8
B) T1
C) T7
D) T3
A) T8
B) T1
C) T7
D) T3
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43
A physician who fills in temporarily for another physician is a(n) ________.
A) Ambulatory Physician
B) Locum Tenens Physician
C) Hospitalist
D) Primary Physician
A) Ambulatory Physician
B) Locum Tenens Physician
C) Hospitalist
D) Primary Physician
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44
Dr. Franks assisted Dr. Rothwell during Keenan's appendectomy. Which modifier will Dr. Franks report?
A) 62
B) 66
C) 80
D) 77
A) 62
B) 66
C) 80
D) 77
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45
After he completed surgery on Dustin, Dr. Willis retired. Dr. Samson took over the postoperative care for Dustin. What modifier is reported for Dr. Willis's service to Dustin?
A) 54
B) 55
C) 56
D) 57
A) 54
B) 55
C) 56
D) 57
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46
The nursing home's ambulance transported Mrs. Foster. What modifier is used?
A) QM
B) QN
C) AA
D) E1
A) QM
B) QN
C) AA
D) E1
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47
Which of the following modifiers might need a supplemental report?
A) 23
B) 52
C) 53
D) All of these
A) 23
B) 52
C) 53
D) All of these
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48
In many situations when a modifier is used, a ________ is needed for additional clarification.
A) formal report
B) medical report
C) supplemental report
D) circumstance report
A) formal report
B) medical report
C) supplemental report
D) circumstance report
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49
Dr. Adler was concerned about Peter's glucose levels, so he ordered one lab test to be done at 11 am and another at 3 pm. What modifier should be appended to the second test code?
A) 76
B) 91
C) 79
D) 90
A) 76
B) 91
C) 79
D) 90
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50
Anesthesia is administered to a patient with mild systemic disease. What modifier is used?
A) P1
B) P2
C) P3
D) P4
A) P1
B) P2
C) P3
D) P4
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51
How are multiple modifiers sequenced?
A) Service-related modifier closest to the code
B) Personnel modifier closest to the code
C) In numerical order
D) It does not matter
A) Service-related modifier closest to the code
B) Personnel modifier closest to the code
C) In numerical order
D) It does not matter
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52
An example of a HCPCS Level II modifier is:
A) 23.
B) 27.
C) RC.
D) 91.
A) 23.
B) 27.
C) RC.
D) 91.
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