COC Modifiers and Their Application 3

Question 1

Modifier -57 is used when an E/M service results in the initial decision to perform:

Accepted Answer

A major surgery (90-day global)

Answer

A minor procedure (0- or 10-day global)

Answer

An outpatient diagnostic test

Answer

A recurring preventive service

Question 2

Which modifier is used to report a staged or related procedure performed by the same physician during the postoperative period?

Accepted Answer

-58

Answer

-55

Answer

-56

Answer

-79

Question 3

When is HCPCS modifier -GY used?

Accepted Answer

To indicate a service is not covered by Medicare or Medicaid and is statutorily excluded

Answer

To indicate a service is medically necessary but not covered by Medicare

Answer

To report a waiver of liability statement on file

Answer

To indicate a service was provided in a skilled nursing facility

Question 4

Modifier -KX is used in Medicare billing to indicate:

Accepted Answer

Specific required documentation is on file to support medical necessity

Answer

The service was experimental

Answer

The patient is covered under a secondary insurance

Answer

The claim involves duplicate services

Question 5

Which modifier is used to report postoperative management only when the surgeon and postoperative care physician are different?

Accepted Answer

-55

Answer

-54

Answer

-56

Answer

-57

Question 6

Modifier -GA is a HCPCS modifier used to indicate:

Accepted Answer

A waiver of liability statement is on file

Answer

The service was provided to a geriatric patient

Answer

Government assistance was applied to the claim

Answer

The claim involves genetic testing

Question 7

When two or more physicians each perform a portion of a surgical team procedure, the appropriate modifier is:

Accepted Answer

-66

Answer

-62

Answer

-80

Answer

-AS