question

Modifiers may affect

answer

The way payment is made by a third-party payer.

question

Modifiers are used to indicate what type of information.

answer

Bilateral procedure, multiple procedures, service greater than usually required - ALL OF THE ABOVE!

question

Modifier -57, decision for surgery is used on what type of service?

answer

E/M

question

Modifier -79, unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period, is used on what type of service

answer

Surgery.

question

Modifier -51, multiple procedure, is used on what type of service.

answer

Surgery.

question

Modifier -80, assistant surgeon is used when?

answer

A second surgeon provides assistance to the primary surgeon.

question

Modifier -32 is used to indicate a service is mandated. Which of the following is an example of when a service is "mandated."

answer

An insurance company requires a second opinion prior to surgery.

question

Modifier -25, significant, separately identifiable E/M service by the same individual on the same day of the procedure or other srevice, is used to report an E/M service that was

answer

Provided on the same day as a minor procedure performed by the same individual.

question

Modifier -59, distinct procedure, is used to indicate that

answer

Services that are usually bundled into one payment were provided as separate procedures.

question

Modifier -58, staged or related procedure or service by the same physician during the postoperative period, is used to indicate

answer

That a subsequent surgery was planned at the time of the first surgery.

question

Modifier -52 reduced services is used to indicate

answer

A service was reduced without changing the definition of the code.

question

The modifier "-AA" is an example of what type of modifier

answer

HCPCS

question

Multiple modifiers are indicated with which modifier

answer

-99

question

The modifier that indicates only the professional component of the service was provided by

answer

-26

question

Mr. Jones is admitted to the ohsp by the orthopaedic surgeon for severe hip pain. The ortho surgeon provides an initial hospital visit during which it is determined that Mr. Jones had a fractured hip that will require surgical intervention. Mr. Jones is taken later that day to the OR where Dr. Ortho performs the surgical procedure to repair Mr. Jones' hip. Which modifier would you use for the hospital visit

answer

-57

question

Mrs. Smith presented to her physician's office for an office for an upper respiratory infection. The physician examines the patient and prescribes antibiotics. The physician notices the patient has a suspicious looking mole. The physician examined the mole and determined that it should be removed. The mole was removed during the same office visit. The physician bills both an E/M code and a procedure code. which modifier would you use on the E/M code

answer

-25

question

Mrs. Roberts falls at work. She claims that she is alright, but her employer's worker's compensation policy requires that she see a physician to confirm she was not injured when she fell. The physician files a claim to the worker's compensation carrier. Which modifier would you use when reporting the physician's service to the patient?

answer

-32

question

Mr. Coslett has multiple surgeries performed during the same operative session. Which modifier would you use.

answer

-51

question

What modifier would you use if you were coding only for the professional component of a diagnostic procedure.

answer

-26

question

Modifier _______ is used to indicate that services of an outside laboratory were used.

answer

-90

question

These elements would be part of the _____ history; employment, education, use of drugs.

answer

Social

question

Bruising would be an element of review of this organ?

answer

Hematologic.

question

The level of E/M service is based on?

answer

Documentation, key components, contributing factors - ALL OF THE ABOVE.

question

The examination is the _____ portion ofthe E/M service

answer

Objective.

question

Medical decision making is based on the ____ that the physician must consider about the management of a patient's condition

answer

Number of diagnoses, risk of morbidity, amount of data - ALL OF THE ABOVE.

question

The hospital inpatient services subsection is used for patient's admitted to

answer

An acute care facility.

question

The request for advice or opinion from one physician to another physician is this type of service

answer

Consultation.

question

Critical care codes are reported based on

answer

Time

question

Codes from the E/M subsection nursing facilities service are used to report services provided in nursing facilities that used to be known as

answer

Skilled nursing facility, intermediate care facility and long-term care facility - ALL OF THE ABOVE

question

When a physician performs a preventive service, the extent of the exam is determined by the

answer

age.

question

According to information in 99468, what is the age of a neonate

answer

28 days or younger.

question

According to E/M guidelines, a(n) _____ exam encompasses a complete single specialty exam or a complete multisystem exam.

answer

Comprehensive

question

Mr. Smith presents to the emergency department at the local hospital for chest pain and is seen by the ED physician on duty. The physician obtains an extended HPI, an extended ROS, and a pertinent PFSH. What is the level of history.

answer

Detailed.

question

The physician performs an extended exam of the affected body areas and related organ systems. what is the level of the examination.

answer

Detailed.

question

The physician must consider multiple diagnoses and management options. There is a moderate amount of date to be reviewed and the risk of complications or death is moderate. What is the level of the MDM.

answer

Moderate.

question

A new patient presents to he physician's office at which time the physician provides a comprehensive history and exam with a high complexity MDM

answer

99205

question

An initial inpatient consultation with a detailed history, detailed exam and MDM of low complexity.

answer

99253

question

A 40-year-old established patient presents to the physician office for a preventive care exam

answer

999396

question

History and exam of the normal newborn infant in a hospital setting.

answer

99460.

question

A 7-year-old female established patient to the pediatrician complaining of ear pain x3 days. A detailed history is then taken. She has associated fever of 101. Mom treated her with Tylenol. The fever this a.m. is 99. She has had some chills and cough as well as some difficulty. No nausea or vomiting. No prior history of otitis. Brother was sick earlier this week. The physician performed a detailed exam of the ENT as well as limited exam of GI, lungs and heart. Vital signs were taken in the office. The physician diagnosed the patient with otitis media and a upper respiratory infection and prescribed an antibiotic. MDM is stated to be moderate.

answer

99214

question

Clinic note: CC: Patient presents for routine examination. Subjective: Sally is a 42-year-old female patient who presents today for a routine physical exam. Objective: BP 120/80. Pelvic exam normal external genitalia. Vagina without discharge except for a scant amount of white discharge that appears normal. Cervix: Multiparous. Bimanual exam is unremarkable. All systems are within normal limits. ASSESSMENT: Normal BP. Normal pelvic exam. PLAN: endotracheal in 1 year or as needed.

answer

99396

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