Chapter 9 Theory

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All about CPT modifiers

surgical team, 66

When more than two physicians, with technicians and specialized equipment, work together to complete a complicated procedure and each physician has a specific portion of the surgery to complete, they are termed what ____________ ___________, and the modifier is -_______.

No, because it states in the notes for modifier 22 that this modifier should not be appended to an E/M Service

Can modifier -22 be assigned to 99291, 99292 codes ( which are E/M service codes)

22

This modifier indicates an increased service and is overused and results in an increase in payment of 20% to 30%. As such, the assignment of this modifier comes under particularly close scrutiny by third-party payers. What is this modifier? (no hyphen)

intraoperative or surgery

When modifier -54 is assigned, payment for the __________________ portion of the surgical procedure is being requested.

She is incorrect because modifier 32 is only assigned for mandated services, such as police and Workers Compensation and not for requests made by patient, family member, or another physician.

Joan is a new coder at the local clinic. You have been assigned to review her coding before it is submitted to the third-party payer. You note that she assigned modifier -32 to E/M consultation code 99244. The medical record indicates that the request for the second opinion was made by the patient's spouse. Is Joan correct in modifier -32 assignment? Why or why not?

b

Which of these statements is true about modifier -59? a. It is only appended to E/M codes
b. It is only appended to other than E/M codes.

8.8 lbs.

What is the weight in pounds of a 4-kilogram infant?

c

Which of the following statemtns is NOT true about modifier -53?
a. describes circumstances based on the patient's condition.
b. may be used to describe those times when the physician elects to terminate a procedure due to the well-being of the patient.
c. describes circumstances in which the patient cancelled the procedure.
d. may be used to describe ASC reporting of previously scheduled procedure that is partially reduced as a result of extenuating circumstances.

False

True or False: Modifier -57 can be added to Surgery section codes?

a

When adding multiple CPT modifiers to a cdoe, you would list the modifiers from:
a. highest to lowest
b. lowest to highest
c. makes no difference which is listed first.

76

Modifier used to repeat procedure or service by same physician? (no hyphen)

62

Modifier for Two surgeons? (no hyphen)

26

Modifier for Professional component? (no hyphen)

99

Modifier for Multiple modifiers? (no hyphen)

59

Modifier for Distinct Procedural Service? (no hyphen)

32

Modifier for Mandated Service (no hyphen)

25

Modifier for Significant identifiab le E/M service provided by the same physician on the same day as another service or procedure? (no hyphen)

81

Modifierfor Minimum Assistant Surgeon? (no hyphen)

77

Repeat procedure by another physician?

79

Unrelated procedure or service by the same physician during the postoperative period

23

Unusual anesthesia

78

Unplanned return to the operating room for a related procedure during the postopeative period.

54

Surgical care only.

52

Reduced service.

66

Surgical Team

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