COC CPT Procedure Coding 2 — Questions and Answers
Question 1: Which CPT modifier indicates a service was reduced or eliminated at the physician's discretion?
- -52 (Correct answer)
- -53
- -22
- -32
Correct answer: -52
Modifier -52 is used when a service or procedure is partially reduced or eliminated at the physician's discretion.
Question 2: When coding an outpatient surgical procedure, how should postoperative complications managed in the office during the global period be reported?
- No separate code — included in global surgical package (Correct answer)
- A separate E/M code with modifier -24
- A new procedure code with modifier -79
- A return-to-OR code with modifier -78
Correct answer: No separate code — included in global surgical package
Routine postoperative follow-up visits are included in the global surgical package and should not be coded separately.
Question 3: Which CPT code category uses time as the key controlling factor for code selection in E/M coding as of 2021 guidelines?
- Office/outpatient E/M codes (99202–99215) (Correct answer)
- Emergency department codes (99281–99285)
- Hospital observation codes (99217–99220)
- Inpatient consult codes (99241–99245)
Correct answer: Office/outpatient E/M codes (99202–99215)
The 2021 E/M guideline changes allow office/outpatient codes 99202–99215 to be selected based solely on total time on the date of the encounter.
Question 4: What does the CPT symbol '▲' (triangle) next to a code indicate?
- Revised code description (Correct answer)
- New code
- Add-on code
- Exempt from modifier -51
Correct answer: Revised code description
A triangle (▲) next to a CPT code signals that the code's description has been revised from the prior year.
Question 5: Which CPT modifier is used when two surgeons each perform distinct portions of a procedure?
- -62 (Correct answer)
- -66
- -80
- -81
Correct answer: -62
Modifier -62 (two surgeons) is appended when two surgeons work together as co-surgeons, each performing a distinct part of a single procedure.
Question 6: In CPT coding, an 'unlisted procedure' code is used when:
- No specific CPT code adequately describes the service performed (Correct answer)
- The procedure is experimental
- The payer does not cover the service
- The procedure was performed in a hospital outpatient setting
Correct answer: No specific CPT code adequately describes the service performed
Unlisted procedure codes are reported when no existing CPT code accurately describes the service; a special report is typically required.
COC CPT Procedure Coding 2
Which CPT modifier indicates a service was reduced or eliminated at the physician's discretion?