and Correct Solutions Latest Update
MUE is the acronym for:
a. Medicare Unlikely Edits
b. Medically Unnecessary Edits
c. Medicare Unnecessary Edits
d. Medically Unlikely Edits - Answer - d. Medically Unlikely Edits
Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following
Modifiers is allowed?
a. 51
b. 59
c. 25
d. Modifiers are not allowed - Answer - d. Modifiers are not allowed
Which of the following is considered to be an anatomic modifier?
a. 77
b. LD
c. T5
d. Both B and C - Answer - d. Both B and C
Medicare states that reporting bundled codes in addition to the major procedural code is considered to
be unbundling, and if repeated with frequency it is considered to be:
a. Abuse
, b. Fraud
c. Misrepresentation
d. False Claims - Answer - b. Fraud
A patient is scheduled for a laparoscopic procedure that is converted to an open procedure after the
procedure is initiated. Which of the following would be correct coding based on CMS NCCI edits?
a. Bill both procedures.
b. Bill only the laparoscopic procedure since that is what was scheduled.
c. Bill only the open procedure (most extensive).
d. Bill both procedures with a modifier appended to the Column 2 code. - Answer - c. Bill only the open
procedure (most extensive).
NCCI is the acronym for:
a. National Correct Coding Institute
b. National Correct Coding Initiative
c. National Coding Clinic Initiative
d. National Coding Coverage Institute - Answer - b. National Correct Coding Initiative
Services that are integral to the procedure being performed - such as cleaning and prepping the skin,
opening and closing the surgical site, or any cultures being taken are considered:
a. Separately billable.
b. Are separately billable if they require additional time.
c. Are included and never separately billable.
d. Individually by payer. - Answer - c. Are included and never separately billable.
Modifier 59 is used to unbundle procedures with an indicator of 1. Under what circumstances would
modifier 59 NOT be appropriate?