CPT Modifiers & Special Coding Situations Flashcards

Modifier -50 is used to report which type of procedure?

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.

Which modifier indicates that only the professional component of a service was provided by the reporting physician?

Answer: -26

Modifier -26 indicates the professional component only (physician's interpretation and report), while -TC indicates the technical component.

Modifier -59 is used to indicate:

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.

Which modifier is used when a procedure is performed by a resident under the supervision of a teaching physician?

Answer: -GC

Modifier -GC indicates a service performed in part by a resident under the direction of a teaching physician, required for Medicare billing.

Modifier -52 is appended to a CPT code when:

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.

Modifier -62 is used when two surgeons each perform distinct parts of a procedure. This is called:

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.