The Complete Diagnosis Coding Solution 3rd Solution by Shelley Safian - Test Bank

The Complete Diagnosis Coding Solution
3rd Solution By Shelley Safian – Test Bank
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Sample Test
Chapter 03
Introduction to CPT Modifiers

Multiple Choice Questions
1. 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
HCPCS Level II modifiers consist of either two letters or one

letter and one number.

ABHES: 8.c.3. Perform diagnostic and procedural coding
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1. Describe how to use the most current
procedural coding system
CAHIIM: I.A.1. Apply diagnosis/procedure codes according to
current guidelines
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 03.04
Topic: HCPCS/National Level II Modifiers

2. 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
Modifiers are two-character codes that add clarification and

additional details to the procedure code’s original description,
as listed in the main portion of the Current Procedural
Terminology (CPT) book.

Blooms: Understand
current guidelines
Difficulty: 2 Medium
Topic: Procedure Code Modifiers
3. All modifiers consist of:

A. three numbers.
B. three letters.
C. two characters.
D. two letters.
CPT code modifiers are two-character codes that can be

attached to regular codes from the main portion of the CPT
book and to HCPCS Level II codes.

Blooms: Remember
current guidelines
Difficulty: 1 Easy

4. Where are the modifiers listed in the CPT book?

A. Alphabetic Index
B. Appendix A
C. Contents
D. Back Page
A full list of modifiers is contained in Appendix A of the CPT
book.

Blooms: Remember
current guidelines
Difficulty: 1 Easy
5. 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
Modifiers reflect the level of difficulty anesthesiologists must

work to ensure the safe anesthesia of the patient.

Blooms: Understand
current guidelines
Topic: Anesthesia Physical Status Modifiers

6. There are some modifiers only used for:

A. surgery codes.
B. physical therapy codes.
C. pathology codes.
D. ambulatory surgery center codes.
There are three distinct codes that can only be used in the
ambulatory surgery center hospital outpatient: 27, 73, and 74.

Blooms: Understand
current guidelines
Topic: Ambulatory Surgery Center Hospital Outpatient Use
Modifiers
7. 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
healthcare professionals involved in the treatment of the
patient.
D. They indicate that a service or procedure was not
performed in total.
Modifiers 62, 80, 81, and 82 are personnel modifiers that relate
to the healthcare professional involved.

Blooms: Understand
current guidelines
Topic: Personnel Modifiers

8. What is the physical status modifier for a brain-dead

patient?
A. P2
B. P6
C. P1
D. P5
Physical status modifier P6 is a modifier used to indicate the

patient is a brain-dead patient whose organs are being
removed for donor purposes.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
9. What modifier indicates anesthesia was administered by

the surgeon performing the procedure?
A. 47
B. 50
C. 51
D. 59
Modifier 47 represents that regional or general anesthesia was

done by the surgeon.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

10. Supplemental reports are required whenever this
modifier is used:
A. 77.
B. 50.
C. 57.
D. 26.
Documentation of medical necessity is required when the

modifier 77 is used. There must be a medical need to repeat
the procedure and to obtain a second set of information in
order for its use to be appropriate.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
Topic: Supplemental Reports
11. Which modifier is used to identify a staged or related

procedure?
A. 25
B. 58
C. 23
D. 59
The modifier 58 is used when, before or during the first

surgery, the decision is made to stage the procedure over time
or to perform multiple procedures.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

12. What modifier is used to indicate when both a

diagnostic and screening mammogram are done on the
same day on the same patient for performance and
payment?
A. QM
B. LC
C. GG
D. LM
Modifier GG is used to indicate performance and payment of a

screening mammogram and diagnostic mammogram on the
same patient on the same day.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
13. 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.
Physical status modifiers are an indicator of the level of

complexity of the services required to treat that patient.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

14. 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
Under some circumstances, highly complex procedures are

carried out by a surgical team.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
15. P3 is an example of a:
A. surgical team modifier.
B. physical status modifier.
C. ambulatory surgery center modifier.
D. multiple procedure modifier.
Physical status modifier P3 is used to indicate the patient has

a severe systemic disease.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

16. Modifier 66 is an example of a:

A. physical status modifier.
B. personnel modifier.
C. ambulatory surgery center modifier.
D. HCPCS Level II modifier.
Personal modifiers explain the healthcare professionals

involved in the treatment of the patient.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
17. 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
When a procedure is performed on the upper right eyelid, the
modifier E3 is used.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

18. 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
When a bilateral procedure is performed, modifier 50 is

appended to the modifier if the CPT codes do not state
laterality.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
Topic: CPT Code Modifiers
19. 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
Service-related modifiers are sequenced before other CPT and

then HCPCS Level II modifiers.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
Topic: Sequencing Multiple Modifiers

20. 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
LT is used to identify procedures performed on the left side of

the body.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
21. The patient was taken to the procedure room at the

ASC for a prostectomy 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
Due to extenuating circumstances or those that threaten the

well-being of the patient, the physician may terminate a
surgical procedure after the administration of anesthesia.
Modifier 74 is used.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

22. 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
LD is used for procedures on the left anterior descending

coronary artery.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
23. 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. decease reimbursement for the facility.
A modifier will provide explanation to the third-party payer that

directly relates to the reimbursement that the physician or
facility will receive.

Blooms: Understand
current guidelines

24. 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 modifier 63 is used for infants weighing less than 4 kg.

Procedures done on these infants are significantly more
complex than they would be when performed on other
patients.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
25. 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
Modifier 26, professional component, is used when there is

both a professional and a technical component to a procedure.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

26. 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
Laterality, physical status, and personnel providing service all

explain special circumstances related to a procedure.

Blooms: Remember
current guidelines
Difficulty: 1 Easy
27. When an arthroscopy is done on both knees, append

modifier:
A. 25.
B. 22.
C. 50.
D. 51.
Modifier 50 is used when a procedure is performed bilaterally.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

28. When the surgeon administers the anesthesia and

performs the procedure, use modifier:
A. 23.
B. 47.
C. 26.
D. 62.
Modifier 47 describes the situation in which the same

physician delivers regional or general anesthesia and performs
the procedure.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
29. Modifier P1 can be appended to only a(n):

A. evaluation and management code.
B. anesthesia code.
C. surgery code.
D. radiology code.
Physical status modifiers P1–P6 may be appended only to

codes from the Anesthesia section of the CPT book.

Blooms: Understand
current guidelines

30. Anesthesia is administered to a normal healthy

person. Append modifier:
A. P1.
B. P2.
C. P3.
D. P4.
P1 is used for a normal healthy patient.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
31. Both Dr. Carter and Dr. Minton operate on Mrs. Smith.
Explain this with modifier:
A. 56.
B. 62.
C. 50.
D. 77.
Modifier 62 is used when two surgeons worked on the patient.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

32. Dr. Files removed a cyst from Jane’s left thumb.
Indicate this with modifier:
A. F5.
B. F1.
C. FA.
D. FB.
Modifier FA indicates the procedure was done on the left hand

thumb.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
33. Dr. Farber provided only surgical care for James.

Report this with modifier:
A. 54.
B. 55.
C. 56.
D. 58.
Modifier 54 is used when a physician provides only surgical

care.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

34. 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.
Modifier 32 is used when the service is provided because a

third-party payer has mandated that it be provided.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
35. 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.
Modifier 73 is used when a surgery is discontinued prior to the

administration of anesthesia.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
Topic: CPT Code Modifier

36. 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.
Modifier 23 is used to report the administration of general
anesthesia that was required for a procedure that normally
requires either no anesthesia or local anesthesia.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
37. During this encounter, Warren agrees for Dr. Dyan to

schedule his surgery. Report this with modifier:
A. 56.
B. 24.
C. 54.
D. 57.
Modifier 57 is used to indicate when the decision to perform

surgery was made. It is appropriate for use only with E/M and
ophthalmologic services.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

38. 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
Modifier 66 is used when a surgical team is used on a

procedure.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
39. 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
Modifier 53 is used for a discontinued procedure when the

patient’s well-being is threatened.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

40. GH is an example of what kind of modifier?

A. CPT
B. ASC
C. HCPCS Level II
D. None of these
GH is a HCPCS Level II modifier indicating diagnostic

mammogram converted from screening mammogram on the
same day.

Blooms: Understand
current guidelines
41. Dr. Perez operated on Erin’s upper right eyelid. What

modifier is used?
A. E1
B. E2
C. E3
D. E4
Modifier E3 is used to indicate a procedure was performed on

the upper right eyelid.

Blooms: Apply
current guidelines
Difficulty: 3 Hard

42. Anesthesia is administered to a patient with mild

systemic disease. What modifier is used?
A. P1
B. P2
C. P3
D. P4
Modifier P2 is used to indicate the patient has a mild systemic

disease.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
43. 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
Modifier 54 is used to indicate that Dr. Willis only provided the

surgical care.

Blooms: Apply
current guidelines
Difficulty: 3 Hard
Topic: CPT Code Modifier

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The Complete Diagnosis Coding Solution

3rd Solution By Shelley Safian – Test Bank

To Purchase this Complete Test Bank with Answers Click the

If face any problem or Further information contact us At tbzuiqe@gmail.com

1. How many characters are in a HCPCS Level II Modifier?

HCPCS Level II modifiers consist of either two letters or one

2. What are modifiers used for?

Modifiers are two-character codes that add clarification and

3. All modifiers consist of:

CPT code modifiers are two-character codes that can be

4. Where are the modifiers listed in the CPT book?

5. When is a physical status modifier used?

Modifiers reflect the level of difficulty anesthesiologists must

6. There are some modifiers only used for:

7. What do personnel modifiers explain?

8. What is the physical status modifier for a brain-dead

Physical status modifier P6 is a modifier used to indicate the

9. What modifier indicates anesthesia was administered by

Modifier 47 represents that regional or general anesthesia was

Documentation of medical necessity is required when the

11. Which modifier is used to identify a staged or related

The modifier 58 is used when, before or during the first

12. What modifier is used to indicate when both a

Modifier GG is used to indicate performance and payment of a

13. What does the physical status modifier describe?

Physical status modifiers are an indicator of the level of

14. A patient had a kidney transplant performed and a

Under some circumstances, highly complex procedures are

Physical status modifier P3 is used to indicate the patient has

16. Modifier 66 is an example of a:

Personal modifiers explain the healthcare professionals

17. The patient had a surgical procedure performed on

18. A patient had a biopsy performed on both of her

When a bilateral procedure is performed, modifier 50 is

19. Which of the following codes shows properly

Service-related modifiers are sequenced before other CPT and

20. A patient had a left knee total knee arthroplasty

LT is used to identify procedures performed on the left side of

21. The patient was taken to the procedure room at the

Due to extenuating circumstances or those that threaten the

22. A patient had a left heart catheterization and a drug

LD is used for procedures on the left anterior descending

A modifier will provide explanation to the third-party payer that

24. A surgical procedure is done on an infant weighing

A modifier 63 is used for infants weighing less than 4 kg.

25. A radiologist reviews and interprets a patient’s x-ray

Modifier 26, professional component, is used when there is

26. Modifiers are used to explain special circumstances

Laterality, physical status, and personnel providing service all

27. When an arthroscopy is done on both knees, append

Modifier 50 is used when a procedure is performed bilaterally.

28. When the surgeon administers the anesthesia and

Modifier 47 describes the situation in which the same

29. Modifier P1 can be appended to only a(n):

Physical status modifiers P1–P6 may be appended only to

30. Anesthesia is administered to a normal healthy

P1 is used for a normal healthy patient.

Modifier 62 is used when two surgeons worked on the patient.

Modifier FA indicates the procedure was done on the left hand

33. Dr. Farber provided only surgical care for James.

Modifier 54 is used when a physician provides only surgical

34. Hartswell Insurance mandates Roger have a

Modifier 32 is used when the service is provided because a