CPC CPT Modifiers & Special Coding Situations 1 — Questions and Answers
Question 1: Modifier -50 is used to report which type of procedure?
- A procedure performed by two surgeons
- A bilateral procedure performed during the same operative session (Correct answer)
- A procedure that requires assistant surgeon services
- A procedure performed in two separate operative sessions
Correct answer: A bilateral procedure performed during the same operative session
Modifier -50 indicates a bilateral procedure performed during the same operative session on symmetric structures.
Question 2: Which modifier indicates that only the professional component of a service was provided by the reporting physician?
- -TC
- -26 (Correct answer)
- -52
- -53
Correct answer: -26
Modifier -26 indicates the professional component only (physician's interpretation and report), while -TC indicates the technical component.
Question 3: Modifier -59 is used to indicate:
- A service was reduced at the physician's discretion
- A distinct procedural service separate from other services performed on the same day (Correct answer)
- A service was discontinued due to complications
- Two surgeons performed a procedure together
Correct answer: A distinct procedural service separate from other services performed on the same day
Modifier -59 indicates a distinct procedural service, used to bypass NCCI edits when procedures are appropriately reported together.
Question 4: Which modifier is used when a procedure is performed by a resident under the supervision of a teaching physician?
- -80
- -GC (Correct answer)
- -AS
- -62
Correct answer: -GC
Modifier -GC indicates a service performed in part by a resident under the direction of a teaching physician, required for Medicare billing.
Question 5: Modifier -52 is appended to a CPT code when:
- A procedure was completely discontinued
- A service was reduced or less extensive than described (Correct answer)
- Two surgeons operated on the same patient
- The patient had a complication during the procedure
Correct answer: A service was reduced or less extensive than described
Modifier -52 indicates that a service was reduced or less extensive than the full descriptor, and reimbursement is typically reduced.
Question 6: Modifier -62 is used when two surgeons each perform distinct parts of a procedure. This is called:
- Co-surgery (Correct answer)
- Assistant-at-surgery
- Team surgery
- Teaching surgery
Correct answer: Co-surgery
Modifier -62 indicates co-surgery, where two surgeons perform distinct parts of a single reportable procedure and each bills with modifier -62.
CPC CPT Modifiers & Special Coding Situations 1
Modifier -50 is used to report which type of procedure?