To assign modifier ______correctly, two physicians of different ________ must
have worked together as co-surgeons and each surgeon dictated his/her own
operative report. - CORRECT ANSWER --62
specialties
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.... - CORRECT ANSWER -co-surgeons
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? - CORRECT ANSWER --22
When adding multiple CPT modifiers to a code, you would list the modifiers from:
When adding multiple HCPCS modifiers, list in:
If CPT modifiers and HCPCS modifiers are both used, list: - CORRECT ANSWER -
CPT- highest to lowest
HCPS-ascending alphabetical order
both- CPT (highest to lowest) then HCPS (ascend. alpha.)
,What part of the CPT manual lists a full description for all modifiers? - CORRECT
ANSWER -appendix A
When a CPT codes does not fully explain an unusual procedure,what should be
added to the code? - CORRECT ANSWER -modifier
Third-Party payers require this modifier for a mandated service. - CORRECT
ANSWER --32
(like a rape test required by police, or phyiscal exam needed for workers comp;
third-party payer will pay 100% for mandated services)
Modifier -47, anesthesia by the surgeon, is never added to what CPT code? -
CORRECT ANSWER -Anesthesia Code
How many units of service may be billed when reporting the -50 modifier
(bilateral) to Medicare? - CORRECT ANSWER -one unit
(For medicare, just submit 27447-50 for procedure done left and right; whereas
other payers want two lines 27447 and 27447-50.)
When reporting -51 modifier to indicate multiple procedure performed, which
procedure should be reported first on the claim? - CORRECT ANSWER -Primary
Procedure
Medicare considers what service to be part of the surgery and bundled payment
not allowing the -56 modifier? - CORRECT ANSWER -preoperative
,E&M services provided the day before or the day of a major surgery are included
in what package? - CORRECT ANSWER -Global Day
Modifier -63 indicates procedure provided to a neonate or infant up to what
weight? - CORRECT ANSWER -4 kg or 8.8 lbs
A surgical team consists of how many physicians? - CORRECT ANSWER -More than
two
What is defined as a place of service specifically equipped and staffed for the sole
purpose of performing procedures? - CORRECT ANSWER -Operating Room
How many modifier area are available on a CMS-1500 insurance claim form for
one-line item charge? - CORRECT ANSWER -four
Describing a physician's services in radiology or pathology. - CORRECT ANSWER -
Professional component
Describing the services provided by the facility. - CORRECT ANSWER -Technical
Component
Bundling together of time effort and services for a specific procedure into one
code instead of reporting each component separately - CORRECT ANSWER -
Surgical Package
Code assignments in the E/M section varies according to three factors: - CORRECT
ANSWER -1. place of service
, 2. type of service
3. patient status
Type of service (for E/M) examples - CORRECT ANSWER -consultation, admission,
newborn care, office visit
Six sections of the CPT manual - CORRECT ANSWER -Evaluation and Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
Patient status (for E/M) - CORRECT ANSWER -new, established, outpatient,
inpatient
A new patient is one who has not received a face-to-face professional service
from that physician or another physician in the same practice of the same
specialty for _____ years. - CORRECT ANSWER -3 years
Another name for the HCPCS Level II is: - CORRECT ANSWER -national codes
The face-to-face encounter between a physician and a patient for primary
management of the patient's health status is a/an _____. - CORRECT ANSWER -
office visit
have worked together as co-surgeons and each surgeon dictated his/her own
operative report. - CORRECT ANSWER --62
specialties
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.... - CORRECT ANSWER -co-surgeons
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? - CORRECT ANSWER --22
When adding multiple CPT modifiers to a code, you would list the modifiers from:
When adding multiple HCPCS modifiers, list in:
If CPT modifiers and HCPCS modifiers are both used, list: - CORRECT ANSWER -
CPT- highest to lowest
HCPS-ascending alphabetical order
both- CPT (highest to lowest) then HCPS (ascend. alpha.)
,What part of the CPT manual lists a full description for all modifiers? - CORRECT
ANSWER -appendix A
When a CPT codes does not fully explain an unusual procedure,what should be
added to the code? - CORRECT ANSWER -modifier
Third-Party payers require this modifier for a mandated service. - CORRECT
ANSWER --32
(like a rape test required by police, or phyiscal exam needed for workers comp;
third-party payer will pay 100% for mandated services)
Modifier -47, anesthesia by the surgeon, is never added to what CPT code? -
CORRECT ANSWER -Anesthesia Code
How many units of service may be billed when reporting the -50 modifier
(bilateral) to Medicare? - CORRECT ANSWER -one unit
(For medicare, just submit 27447-50 for procedure done left and right; whereas
other payers want two lines 27447 and 27447-50.)
When reporting -51 modifier to indicate multiple procedure performed, which
procedure should be reported first on the claim? - CORRECT ANSWER -Primary
Procedure
Medicare considers what service to be part of the surgery and bundled payment
not allowing the -56 modifier? - CORRECT ANSWER -preoperative
,E&M services provided the day before or the day of a major surgery are included
in what package? - CORRECT ANSWER -Global Day
Modifier -63 indicates procedure provided to a neonate or infant up to what
weight? - CORRECT ANSWER -4 kg or 8.8 lbs
A surgical team consists of how many physicians? - CORRECT ANSWER -More than
two
What is defined as a place of service specifically equipped and staffed for the sole
purpose of performing procedures? - CORRECT ANSWER -Operating Room
How many modifier area are available on a CMS-1500 insurance claim form for
one-line item charge? - CORRECT ANSWER -four
Describing a physician's services in radiology or pathology. - CORRECT ANSWER -
Professional component
Describing the services provided by the facility. - CORRECT ANSWER -Technical
Component
Bundling together of time effort and services for a specific procedure into one
code instead of reporting each component separately - CORRECT ANSWER -
Surgical Package
Code assignments in the E/M section varies according to three factors: - CORRECT
ANSWER -1. place of service
, 2. type of service
3. patient status
Type of service (for E/M) examples - CORRECT ANSWER -consultation, admission,
newborn care, office visit
Six sections of the CPT manual - CORRECT ANSWER -Evaluation and Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
Patient status (for E/M) - CORRECT ANSWER -new, established, outpatient,
inpatient
A new patient is one who has not received a face-to-face professional service
from that physician or another physician in the same practice of the same
specialty for _____ years. - CORRECT ANSWER -3 years
Another name for the HCPCS Level II is: - CORRECT ANSWER -national codes
The face-to-face encounter between a physician and a patient for primary
management of the patient's health status is a/an _____. - CORRECT ANSWER -
office visit
