Name: ___________________________ Date : ___________________

MODIFIER TEST

1. When two surgeons work together as primary surgeons performing distinct part(s) of a
single reportable procedure, each surgeon should report his/her distinct operative work by
adding which of the following modifiers?

a. 54 b. 66 c. 59 d. 62

2. When a patient is in a postoperative period and returns to the operating room for an unrelated
procedure by the same physician, which of the following modifiers would you attach to the
procedure being performed?

a. 59 b. 24 c. 78 d. 79

3. Evaluation and Management services were performed on an established patient in which the
decision to perform a major surgery scheduled for the following morning was made. The patient
was counseled for 15 minutes regarding treatment options, risks, and projected outcome.
Which of the following modifiers would be appended to the service performed?

a. 56 b. 52 c. 50 d. 57

4. What modifier best describes a surgery performed on the right foot, fourth digit?

a. T8 b. T4 c. RT d. F8

5. What modifier should be used for an incomplete colonoscopy when the patient was prepared
for a full colonoscopy?

a. 78 b. 52 c. 24 d. None of the above

6. Which modifier would be attached to the code for a surgical salpingostomy if the surgeon
provided regional anesthesia and completed the procedure?

A) P1 B) 47 C) 25 D) 59

7. Which HCPCS modifier is used to indicate cancellation of surgery after anesthesia due to
poor patient condition in a Medicare patient? (For facility coding)

A) No modifier is used because the procedure is already started

B) 73 C) 74 D) 52 1

8. Which modifier would you use if a reexcision procedure is performed during the postoperative
period of the primary excision of a malignant lesion?

a. 76 b. 59 c. 58 d. 79
9. What modifier should you report when the same physician provided a rereduction of a
fracture?

a. 76 b. 59 c. 77 d. 54

10. A patient was placed under general anesthesia to have a simple incision and removal of a
foreign body from the subcutaneous tissue. This procedure usually requires local anesthesia.
Due to unusual circumstances, which required general anesthesia, what modifier would best
describe this situation?

a. 47 b. 22 c. 23 d. P6

11. What modifier would best describe a blepharoplasty to the upper right eyelid?

a. E1 b. 51 c. E3 d. RT

12. Which HCPCS modifier indicates the great toe of the right foot?

A. T1 B. T3 C. T4 D. T5

Provide Modifier for each:

1. The surgeon performed a repair of an enterocele using an abdominal approach (57270) on a

2. During a radical orchiectomy with abdominal exploration for an extensive primary, malignant
neoplasm (54535) of the left descended testis, the patient began to hemorrhage (a
complication). After considerable time and effort, which extended the surgery by 60 minutes,
the hemorrhage was controlled. 22

3. An extremely anxious and combative elderly man presented to the outpatient sameday
surgery unit for a gastroscopy due to hematemesis and suspected peptic ulcer. The patient was
unable to cooperate. The physician determined that, because of the patient’s advanced
Alzheimer’s, general anesthesia during this procedure, which usually does not require
anesthesia, was the best approach to use with the patient. What modifier would the
anesthesiologist report when reporting this service? 23

4. Dr. Foster admitted a patient to a skilled nursing facility because of the patient’s advanced
dementia due to Alzheimer’s disease (during the global period for a herniorrhaphy that Dr.
Foster performed). What modifier would be added to the admission service? 24

5. A patient came to the office twice in one day to see the same physician for unrelated
problems. What modifier would be added to the code for the second office visit? 25

6. A patient underwent bilateral carpal tunnel surgery. When you assign a code, what modifier
would you be certain to use? 50

7. A 60 year old female patient is referred to a radiology laboratory by her general physician. The
laboratory takes the xrays requested and sends them on to a radiologist to interpret and to
develop the written report that is sent to the general physician. If you were coding for the
radiologist, what modifier would you add to indicate the service provided by the radiologist?
26

8. Workers’ Compensation referred a patient to a physician for a mandatory examination to

9. Dr. Ramus administers regional anesthesia by intravenous injection (also known as a Bier
block) for a surgical procedure on the patient’s lower arm. Dr. Ramus then performs the surgical
procedure. What modifier would be added to the surgical code? 47

10. Mrs. Knight has a diagnostic surgical biopsy of deep cervical lymph nodes on May 8, and
the pathology report comes back showing secondary malignancy with the primary site unknown.
Mrs. Knight elects to have a lymphadenectomy on May 11. What modifier would be used with
the lymphadenectomy code? 58

11. The intraoperative service for a total esophagectomy without reconstruction (43124)
54

12. The postoperative care only for a radical mastectomy including pectoral muscles, axillary,
and internal mammary lymph nodes 55

13. The procedure in above question when only the preoperative service is provided 56

14. Dr. Edwards, a cardiologist, and Dr. Mathews, a general surgeon, worked together as primary
surgeons on a complex surgical case. What modifier would be added to the CPT surgery codes
for the services of both Dr. Edwards and Dr. Mathews? 62

15. A team of physicians with different specialties, along with a highly skilled team of technical
personnel, performed a liver transplant for a patient with chronic viral hepatitis C that has
resulted in cirrhosis of the liver. Which modifier would indicate the surgical team concept? 66

16. Dr. Stenopolis served as a surgical assistant to Dr. Edwards in a quadruple bypass
procedure. Dr. Stenopolis’ services were reported by using this modifier: 80

17. In the middle of the bypass procedure in Question 3, the patient experienced severe
complications. Dr. Edwards asked Dr. Loren to come into the operating room to temporarily
assist with the surgery to stabilize the patient. What modifier would be used when reporting the
service Dr. Loren provided? 81

18. A patient had a hernia repair and two days later returned to the operating room for a
dehiscence of the incision. When coding the secondary hernia repair, which modifier would you
add onto the surgical code? 78