CPT Modifiers UPDATED ACTUAL
Questions and CORRECT Answers
-24 - CORRECT ANSWER - Unrelated Evaluation and Management service by the same
physician or other qualified health care professional during a postoperative period. Not to be
used if the global period is 0. Not to be used if the surgery/procedure is not provided in the same
practice.
-25 - CORRECT ANSWER - Significant, separately, identifiable Evaluation and
Management service by the same physician or other health care professional on the same day of
the procedure or other service. Attach the modifier to the visit code then list the codes for the
other procedures.
CPT modifiers - CORRECT ANSWER - clarify services and procedures performed by
providers. They indicate that the description of the service or procedure performed has been
modified.
functional modifier (pricing modifier) - CORRECT ANSWER - assists in reimbursement
decision-making
informational modifiers - CORRECT ANSWER - clarify aspects of the procedure or
service provided for the payer
-33 - CORRECT ANSWER - Preventive Service
-26 - CORRECT ANSWER - Professional and Technical Components. Is it used for
example by the contracting physicians. It is added to show the use of the hospital additional
personal and hospital equipment. If the hospital provides technician, film, and equipment and
does the interpretation and report, no modifier is necessary.
-32 - CORRECT ANSWER - Mandated Services. This services can be mandated by third-
party payer, governmental, legislative, or regulatory requirement. Not to be used on patient
initiated-services.
, -99 - CORRECT ANSWER - Multiple Modifiers
-57 - CORRECT ANSWER - Decision for Surgery. An E/M service that resulted in the
initial decision to perform the surgery may be identified by adding this modifier to the
appropriate level of E/M service. This modifier provides separate E/M payment as it indicates
that the E/M encounter determined the surgical decision. Not to be used for decision to perform a
minor procedure (0-10 follow-up days).
-22 - CORRECT ANSWER - Increased Procedural Services. When the work required to
provide a service is substantially greater than typically required. Not to be used for reporting
additional minimal work or time.
-52 - CORRECT ANSWER - Reduced Services. It indicates that a service or procedure
was not fully completed within the given code descriptor. Not intended for cancellation of
services nor is it to be used to reduce a patient financial responsibility.
-53 - CORRECT ANSWER - Discontinued Procedure. Due to extenuating circumstances
or those that threaten the well-being of the patient. It is not to be used to report the elective
cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation
in the operating suite.
-73 - CORRECT ANSWER - Discontinued Outpatient Hospital/Ambulatory Surgery
Center (ASC) Procedure Prior to the Administration of Anesthesia.
-74 - CORRECT ANSWER - Discontinued Outpatient Hospital/Ambulatory Surgery
(ASC) Procedure After the Administration of Anesthesia.
-54 - CORRECT ANSWER - Surgical Care Only.When one physician performs a surgical
procedure and another provides preoperative and/or postoperative management, surgical services
may be identified by adding this modifier to the usual procedure number.
Questions and CORRECT Answers
-24 - CORRECT ANSWER - Unrelated Evaluation and Management service by the same
physician or other qualified health care professional during a postoperative period. Not to be
used if the global period is 0. Not to be used if the surgery/procedure is not provided in the same
practice.
-25 - CORRECT ANSWER - Significant, separately, identifiable Evaluation and
Management service by the same physician or other health care professional on the same day of
the procedure or other service. Attach the modifier to the visit code then list the codes for the
other procedures.
CPT modifiers - CORRECT ANSWER - clarify services and procedures performed by
providers. They indicate that the description of the service or procedure performed has been
modified.
functional modifier (pricing modifier) - CORRECT ANSWER - assists in reimbursement
decision-making
informational modifiers - CORRECT ANSWER - clarify aspects of the procedure or
service provided for the payer
-33 - CORRECT ANSWER - Preventive Service
-26 - CORRECT ANSWER - Professional and Technical Components. Is it used for
example by the contracting physicians. It is added to show the use of the hospital additional
personal and hospital equipment. If the hospital provides technician, film, and equipment and
does the interpretation and report, no modifier is necessary.
-32 - CORRECT ANSWER - Mandated Services. This services can be mandated by third-
party payer, governmental, legislative, or regulatory requirement. Not to be used on patient
initiated-services.
, -99 - CORRECT ANSWER - Multiple Modifiers
-57 - CORRECT ANSWER - Decision for Surgery. An E/M service that resulted in the
initial decision to perform the surgery may be identified by adding this modifier to the
appropriate level of E/M service. This modifier provides separate E/M payment as it indicates
that the E/M encounter determined the surgical decision. Not to be used for decision to perform a
minor procedure (0-10 follow-up days).
-22 - CORRECT ANSWER - Increased Procedural Services. When the work required to
provide a service is substantially greater than typically required. Not to be used for reporting
additional minimal work or time.
-52 - CORRECT ANSWER - Reduced Services. It indicates that a service or procedure
was not fully completed within the given code descriptor. Not intended for cancellation of
services nor is it to be used to reduce a patient financial responsibility.
-53 - CORRECT ANSWER - Discontinued Procedure. Due to extenuating circumstances
or those that threaten the well-being of the patient. It is not to be used to report the elective
cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation
in the operating suite.
-73 - CORRECT ANSWER - Discontinued Outpatient Hospital/Ambulatory Surgery
Center (ASC) Procedure Prior to the Administration of Anesthesia.
-74 - CORRECT ANSWER - Discontinued Outpatient Hospital/Ambulatory Surgery
(ASC) Procedure After the Administration of Anesthesia.
-54 - CORRECT ANSWER - Surgical Care Only.When one physician performs a surgical
procedure and another provides preoperative and/or postoperative management, surgical services
may be identified by adding this modifier to the usual procedure number.
