CCS EXAM PRACTICE TEST – AHIMA. 100 Questions with Answers and
Detailed Rationales. Based on 2025/2026 Exam Blueprint.
Domain 1: Coding Knowledge & Skills (Questions 1–50)
1. To assign modifier ______ correctly, two physicians of different ________ must have
worked together as co-surgeons and each surgeon dictated his/her own operative report.
A) 62, specialties
B) 66, specialties
C) 80, surgeons
D) 22, specialties
Answer: A) 62, specialties
Rationale: Modifier 62 (Two Surgeons) is used when two surgeons of different specialties work
together as co-surgeons, each performing a distinct portion of a complicated procedure. Each
surgeon must dictate their own operative report. Modifier 66 (Surgical Team) is for more than
two surgeons. Modifier 80 is for assistant surgeon. Modifier 22 (Increased Procedural Services)
is for increased complexity by a single surgeon .
2. When more than two physicians work together to complete a complicated procedure and
each physician has a specific portion of the surgery to complete, they are called:
A) Co-surgeons
B) Assistant surgeons
C) Surgical team
D) Consultants
Answer: C) Surgical team
,Rationale: A surgical team consists of more than two physicians working together, each
performing a distinct portion of a complicated procedure. This is reported with modifier 66. Co-
surgeons (modifier 62) specifically refers to two surgeons .
3. This modifier indicates an increased service and is overused, resulting 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) Modifier 22
B) Modifier 52
C) Modifier 59
D) Modifier 51
Answer: A) Modifier 22
Rationale: Modifier 22 (Increased Procedural Services) is used when the work required to
perform a procedure is substantially greater than typically required. It can increase payment by
20–30%, making it a target for payer scrutiny. Modifier 52 (Reduced Services) decreases
payment. Modifier 59 (Distinct Procedural Service) identifies separate procedures. Modifier 51
(Multiple Procedures) indicates multiple procedures performed during the same session .
4. When adding multiple CPT modifiers to a code, you would list the modifiers from:
A) Highest to lowest
B) Lowest to highest
C) Alphabetical order
D) Any order is acceptable
Answer: A) Highest to lowest
Rationale: When adding multiple CPT modifiers, list them from highest to lowest (e.g., 22, 51,
50). For HCPCS modifiers, list in ascending alphabetical order. If both CPT and HCPCS modifiers
are used, list CPT modifiers first (highest to lowest), then HCPCS modifiers (ascending
alphabetical) .
,5. What part of the CPT manual lists a full description for all modifiers?
A) Appendix A
B) Appendix B
C) Appendix C
D) Appendix D
Answer: A) Appendix A
Rationale: Appendix A of the CPT manual contains a complete list of all CPT modifiers with
their full descriptions. Appendix B contains summary of additions, deletions, and revisions.
Appendix C contains clinical examples. Appendix D contains summary of CPT add-on codes .
6. When a CPT code does not fully explain an unusual procedure, what should be added to
the code?
A) Modifier
B) HCPCS code
C) Add-on code
D) Category II code
Answer: A) Modifier
Rationale: When a CPT code does not fully describe the circumstances of a procedure,
a modifier should be added to provide additional information about the service provided.
Modifiers indicate that the service was altered in some way without changing the core code
definition .
7. Third-party payers require this modifier for a mandated service (e.g., rape test required by
police, physical exam needed for workers' compensation).
, A) Modifier 32
B) Modifier 33
C) Modifier 52
D) Modifier 22
Answer: A) Modifier 32
Rationale: Modifier 32 (Mandated Services) is used for services required by a third-party payer,
such as:
Court-ordered examinations
Workers' compensation evaluations
Police-required examinations (e.g., rape kits)
Third-party payers will typically pay 100% for mandated services .
8. Modifier 47 (Anesthesia by Surgeon) is never added to what type of code?
A) Anesthesia codes
B) Surgery codes
C) Radiology codes
D) Pathology codes
Answer: A) Anesthesia codes
Rationale: Modifier 47 (Anesthesia by Surgeon) is used to indicate that the surgeon
administered regional or general anesthesia for a surgical procedure. However, it is never
appended to anesthesia codes—it is appended to the surgical procedure code. Anesthesia
codes have their own modifiers (physical status modifiers) .
9. How many units of service may be billed when reporting modifier 50 (Bilateral) to
Medicare?
A) One unit
B) Two units
Detailed Rationales. Based on 2025/2026 Exam Blueprint.
Domain 1: Coding Knowledge & Skills (Questions 1–50)
1. To assign modifier ______ correctly, two physicians of different ________ must have
worked together as co-surgeons and each surgeon dictated his/her own operative report.
A) 62, specialties
B) 66, specialties
C) 80, surgeons
D) 22, specialties
Answer: A) 62, specialties
Rationale: Modifier 62 (Two Surgeons) is used when two surgeons of different specialties work
together as co-surgeons, each performing a distinct portion of a complicated procedure. Each
surgeon must dictate their own operative report. Modifier 66 (Surgical Team) is for more than
two surgeons. Modifier 80 is for assistant surgeon. Modifier 22 (Increased Procedural Services)
is for increased complexity by a single surgeon .
2. When more than two physicians work together to complete a complicated procedure and
each physician has a specific portion of the surgery to complete, they are called:
A) Co-surgeons
B) Assistant surgeons
C) Surgical team
D) Consultants
Answer: C) Surgical team
,Rationale: A surgical team consists of more than two physicians working together, each
performing a distinct portion of a complicated procedure. This is reported with modifier 66. Co-
surgeons (modifier 62) specifically refers to two surgeons .
3. This modifier indicates an increased service and is overused, resulting 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) Modifier 22
B) Modifier 52
C) Modifier 59
D) Modifier 51
Answer: A) Modifier 22
Rationale: Modifier 22 (Increased Procedural Services) is used when the work required to
perform a procedure is substantially greater than typically required. It can increase payment by
20–30%, making it a target for payer scrutiny. Modifier 52 (Reduced Services) decreases
payment. Modifier 59 (Distinct Procedural Service) identifies separate procedures. Modifier 51
(Multiple Procedures) indicates multiple procedures performed during the same session .
4. When adding multiple CPT modifiers to a code, you would list the modifiers from:
A) Highest to lowest
B) Lowest to highest
C) Alphabetical order
D) Any order is acceptable
Answer: A) Highest to lowest
Rationale: When adding multiple CPT modifiers, list them from highest to lowest (e.g., 22, 51,
50). For HCPCS modifiers, list in ascending alphabetical order. If both CPT and HCPCS modifiers
are used, list CPT modifiers first (highest to lowest), then HCPCS modifiers (ascending
alphabetical) .
,5. What part of the CPT manual lists a full description for all modifiers?
A) Appendix A
B) Appendix B
C) Appendix C
D) Appendix D
Answer: A) Appendix A
Rationale: Appendix A of the CPT manual contains a complete list of all CPT modifiers with
their full descriptions. Appendix B contains summary of additions, deletions, and revisions.
Appendix C contains clinical examples. Appendix D contains summary of CPT add-on codes .
6. When a CPT code does not fully explain an unusual procedure, what should be added to
the code?
A) Modifier
B) HCPCS code
C) Add-on code
D) Category II code
Answer: A) Modifier
Rationale: When a CPT code does not fully describe the circumstances of a procedure,
a modifier should be added to provide additional information about the service provided.
Modifiers indicate that the service was altered in some way without changing the core code
definition .
7. Third-party payers require this modifier for a mandated service (e.g., rape test required by
police, physical exam needed for workers' compensation).
, A) Modifier 32
B) Modifier 33
C) Modifier 52
D) Modifier 22
Answer: A) Modifier 32
Rationale: Modifier 32 (Mandated Services) is used for services required by a third-party payer,
such as:
Court-ordered examinations
Workers' compensation evaluations
Police-required examinations (e.g., rape kits)
Third-party payers will typically pay 100% for mandated services .
8. Modifier 47 (Anesthesia by Surgeon) is never added to what type of code?
A) Anesthesia codes
B) Surgery codes
C) Radiology codes
D) Pathology codes
Answer: A) Anesthesia codes
Rationale: Modifier 47 (Anesthesia by Surgeon) is used to indicate that the surgeon
administered regional or general anesthesia for a surgical procedure. However, it is never
appended to anesthesia codes—it is appended to the surgical procedure code. Anesthesia
codes have their own modifiers (physical status modifiers) .
9. How many units of service may be billed when reporting modifier 50 (Bilateral) to
Medicare?
A) One unit
B) Two units
