CPC Coding Guidelines & Modifiers Practice Questions
Coding Guidelines & Modifiers makes up 4 of every 50 questions on a Tigertest CPC practice test. Here are 10 of the 16 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Based on AAPC's published CPC exam areas, the ICD-10-CM Official Guidelines, CMS rules and CPT conventions. Original questions; no code-book lookups.
1. Which modifier reports a significant, separately identifiable E/M service on the same day as a procedure?
- A.Modifier 24
- B.Modifier 25
- C.Modifier 57
- D.Modifier 59
Answer: B. Modifier 25 goes on the E/M when the work goes beyond the usual pre-procedure evaluation. Modifier 59 is for distinct procedures, not E/M services.
2. Modifier 57 is appended to an E/M service that resulted in:
- A.An unrelated postop problem
- B.A repeat of the same procedure
- C.A minor procedure that day
- D.The decision for major surgery
Answer: D. Modifier 57 marks the E/M where the decision for surgery was made, the day before or day of a major (90-day global) procedure. A same-day minor procedure uses 25.
3. Modifier 24 reports an E/M service that is:
- A.Unrelated, during a postop period
- B.Provided by a second surgeon
- C.Part of the routine postop follow-up
- D.The decision for surgery
Answer: A. Modifier 24 tells the payer the E/M during the global period is for a problem unrelated to the surgery. Routine follow-up is included in the surgical package.
4. A planned or staged procedure by the same physician during the global period takes modifier:
- A.Modifier 79
- B.Modifier 76
- C.Modifier 58
- D.Modifier 78
Answer: C. Modifier 58 covers staged, more extensive or therapy procedures related to the first one. It starts a new global period.
5. An unplanned return to the operating room for a complication of the first surgery takes modifier:
- A.Modifier 79
- B.Modifier 77
- C.Modifier 78
- D.Modifier 58
Answer: C. Modifier 78 is an unplanned return to the OR for a related problem in the postop period. Modifier 79 is for an unrelated procedure.
6. An unrelated procedure by the same physician during a postop period takes modifier:
- A.Modifier 79
- B.Modifier 58
- C.Modifier 24
- D.Modifier 78
Answer: A. Modifier 79 shows the procedure is unrelated to the original surgery. Modifier 24 is the equivalent for an unrelated E/M visit.
7. Modifier 26 identifies:
- A.A reduced service
- B.The technical component only
- C.A bilateral procedure
- D.The professional component
Answer: D. Modifier 26 reports the physician's interpretation and report only. The technical component (equipment, staff) uses HCPCS modifier TC.
8. A plus sign (+) before a CPT code means the code is:
- A.Resequenced out of order
- B.An add-on code
- C.A new code this year
- D.Pending FDA approval
Answer: B. Add-on codes are reported only with a primary procedure and are exempt from multiple procedure reduction. Pending FDA approval is a lightning bolt and resequenced codes carry a number sign.
9. In CPT, a bullet symbol before a code indicates:
- A.A telemedicine code
- B.A new code
- C.A revised code
- D.An add-on code
Answer: B. A bullet marks a code new this edition. A triangle marks revised wording, a plus sign an add-on and a star a service suitable for telemedicine.
10. Category III CPT codes describe:
- A.Drugs and supplies
- B.Unlisted procedures
- C.Performance measures
- D.Emerging technology
Answer: D. Category III codes (four digits and a T) track emerging technology and services. Category II codes (four digits and an F) are for performance measurement.
Practice all 16 coding guidelines & modifiers questions, and the rest of the 200-question bank, in the free CPC training sets. Questions you miss come back until you have mastered them.
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