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 morbidly
obese patient, and because of the patient’s obesity, the procedure took a significant amount of
additional time to perform (50 minutes added to the normal time usually required). 22

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 determine

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