CCS CCS CPT & HCPCS Procedure Coding 2 — Questions and Answers
Question 1: CPT modifier -51 is used to indicate:
- A service was provided by a resident under supervision
- Multiple procedures performed by the same provider at the same session other than E/M services or add-on codes (Correct answer)
- A procedure was discontinued after anesthesia was administered
- The procedure was performed on a bilateral body part
Correct answer: Multiple procedures performed by the same provider at the same session other than E/M services or add-on codes
Modifier -51 is appended to secondary and subsequent procedure codes when multiple procedures are performed at the same operative session.
Question 2: CPT Category II codes are used for:
- New or experimental technology not yet assigned a Category I code
- Supplemental tracking codes for performance measurement that are optional and do not affect reimbursement (Correct answer)
- Inpatient-only procedures requiring a hospital setting
- Telemedicine services only
Correct answer: Supplemental tracking codes for performance measurement that are optional and do not affect reimbursement
Category II codes are alphanumeric tracking codes used for quality measurement and data collection but have no reimbursement value.
Question 3: The 'separate procedure' designation in CPT means:
- The procedure is always reported separately regardless of other services
- The procedure is commonly carried out as part of a larger service and should not be reported separately when performed as an integral component (Correct answer)
- The procedure requires its own operative report
- The procedure must be performed by a different surgeon
Correct answer: The procedure is commonly carried out as part of a larger service and should not be reported separately when performed as an integral component
A 'separate procedure' designation means the code should only be reported independently when it is not incidental to another more complex procedure performed at the same session.
Question 4: CPT modifier -59 is used to indicate:
- A procedure was performed by a different surgeon
- A distinct procedural service not normally reported together but appropriate under the circumstances (Correct answer)
- The patient refused part of the service
- The procedure was reduced due to extenuating circumstances
Correct answer: A distinct procedural service not normally reported together but appropriate under the circumstances
Modifier -59 identifies a procedure or service as distinct or independent from other services performed on the same day when other modifiers do not adequately describe the situation.
Question 5: CPT Category III codes (T-codes) are used for:
- Temporary codes for emerging technology, services, and procedures to allow data collection (Correct answer)
- Services requiring prior authorization
- Diagnostic tests only
- Codes that have been deleted from the CPT manual
Correct answer: Temporary codes for emerging technology, services, and procedures to allow data collection
Category III codes are temporary four-digit alphanumeric codes used to track utilization of new and emerging technologies and procedures.
Question 6: The three key components used to select an E/M (Evaluation and Management) level of service are:
- Time, diagnosis, and procedure performed
- History, examination, and medical decision making (Correct answer)
- Chief complaint, past history, and review of systems
- Diagnosis, treatment plan, and follow-up interval
Correct answer: History, examination, and medical decision making
E/M code selection is based on the level of history obtained, the extent of physical examination performed, and the complexity of medical decision making.
CCS CCS CPT & HCPCS Procedure Coding 2
CPT modifier -51 is used to indicate: