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CPT Coding > Ch 10: Chapter Review > Flashcards

Ch 10: Chapter Review Flashcards

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1
Q

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?

A

Co-Surgeons

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2
Q

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?

A

-22 (Increased Procedural Services)

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3
Q

When modifier _____ is assigned, payment for the intraoperative or surgery portion of the surgical procedure is being requested.

A

-54 (Surgical Care Only)

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4
Q

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

A

8.8 lbs

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5
Q

T/F: Modifier -57 can be added to Surgery section codes.

A

False

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6
Q

In what sequence do you add multiple CPT modifiers to a code?

A

Highest to Lowest

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7
Q

What modifier: Repeat procedure or service by same physician?

A

-76

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8
Q

What modifier: Two surgeons

A

-62

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9
Q

What modifier: Professional Component

A

-26

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10
Q

What modifier: Multiple modifiers

A

-99

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11
Q

What modifier: Distinct procedural service

A

-59

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12
Q

What modifier: Mandated service

A

-32

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13
Q

What modifier: Significant identifiable E/M service provided by the same individual on the same day as another service or procedure

A

-25

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14
Q

What modifier: Repeat procedure by another individual

A

-77

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15
Q

What modifier: Minimum assist surgeon

A

-81

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16
Q

What modifier: Unrelated procedure or service by the same individual during the postoperative period

A

-24

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17
Q

What modifier: Unusual anesthesia

A

-23

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18
Q

What modifier: Unplanned return to the operating room for a related procedure during the postoperative period

A

-78

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19
Q

What modifier: Surgical care only

A

-54

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20
Q

What modifier: Reduced services

A

-52

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21
Q

What modifier: Surgical team

A

-66

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22
Q

What part of the CPT manual lists a full description for all modifiers?

A

Appendix A

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23
Q

When a CPT code does not fully explain an unusual procedure, what should be added to the code?

A

Modifier

24
Q

What modifier is applied to a surgical procedure to indicate increased physician work was performed?

A

-22

25
Q

What modifier is applied to indicate a service for which general anesthesia was used when normally local anesthesia would be indicated?

A

-23

26
Q

What modifier is applied to indicate an E&M encounter was performed and not related to a current global period?

A

-24

27
Q

When a patient comes into the office twice in one day for different medical reasons, the -25 modifier should be applied to which visit?

A

Second E/M

28
Q

What modifier indicates the professional component of a diagnostic test?

A

-26

29
Q

Third-party payers require this modifier for a mandated service.

A

-32

30
Q

Modifier -33 indicates a covered preventive service. What organization grades preventive services?

A

US Preventive Services Task Force (USPSTF)

31
Q

Modifier -47, anesthesia by the surgeon, is never added to what CPT codes?

A

Anesthesia codes

32
Q

How many units of service may be billed when reporting -50 modifier to Medicare?

A

One unit

33
Q

When reporting -51 modifier to indicate multiple procedures performed, which procedure should be reported first on the claim?

A

Primary Procedure

34
Q

Some payers may decrease the payment on a procedure when this modifier is applied.

A

-52

35
Q

Modifier -53, discontinued procedure, is never reported with E/M codes or codes based on what?

A

Time

36
Q

Modifier -55 is used for services provided to the patient after what disposition?

A

Discharge from the hospital

37
Q

Medicare considers what service to be part of the surgery and bundled payment not allowing the -56 modifier?

A

Preoperative

38
Q

E/M services provided the day before or the day of a major surgery are included in what package?

A

Global Days

39
Q

A planned procedure intended to include the original procedure plus one or more subsequent procedures is indicated by what modifier?

A

-58

40
Q

Modifier -59 is applicable to all CPT codes except what type of codes?

A
  • E/M codes

- Weekly radiation management

41
Q

When two physicians of different specialities work together as co-surgeons, modifier -62 is supported if the operative note clearly shows what type of services?

A

Distinct, separate service

42
Q

Modifier -63 indicates procedures provided to a neonate or infant up to what weight?

A

4 kg or 8.8 lbs

43
Q

A surgical team consists of how man physicians?

A

More than two

44
Q

To avoid duplicate procedure denials by the SAME provider, what modifier should be applied?

A

-76

45
Q

To avoid duplicate procedure denials by DIFFERENT providers, what modifier should be applied?

A

-77

46
Q

What is defined as a place of service specifically equipped and staged for the sole purpose of performing procedures?

A

Operating/designated procedure room

47
Q

Billing separately for services included in the surgical package is considered what?

A

Fradulent

48
Q

A physician assistant providing assist at surgery would use HCPCS modifier -AS. What modifier would a physician surgical assistant use?

A

-80

49
Q

When an assistant surgeon is present and provides minimum assist for the procedure, what modifier should be applied?

A

-81

50
Q

Hospitals that have affiliations with medical schools are considered what type of facility?

A

Teaching facility

51
Q

When providers use an outside laboratory, who is responsible for billing these Medicare services?

A

Outside laboratory

52
Q

Is it appropriate to bill for repeat lab tests with a -91 modifier when a subsequent test is performed to confirm results of the initial test?

A

No

53
Q

What modifier identifies a lab test is performed using a kit or transportable instrument that wholly or in part consists of a single-use, disposable analytical chamber?

A

-92

54
Q

How many modifier areas are available on a CMS-1500 insurance claim form for one-line item charge?

A

Four

55
Q

When the surgeon transfers postoperative care to another physician, report with what modifier?

A

-54

CPT Coding (41 decks)

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