CPT Modifiers & Special Coding Situations Flashcards
6 cards from real CPC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CPT Modifiers & Special Coding Situations flashcards as text
Add-on codes in CPT are identified by which notation and are NEVER reported:
Answer: A '+' symbol; never reported without a primary procedure code
Add-on codes are identified by a '+' symbol and are always reported in addition to a primary procedure code, never alone.
Modifier -51 (multiple procedures) is appended to which code when multiple procedures are performed?
Answer: The secondary and additional procedures, not the primary
Modifier -51 is appended to the secondary and additional procedures, not to the primary (highest-valued) procedure code.
Category III CPT codes are used for:
Answer: Emerging technology, services, and procedures for data collection
Category III codes are temporary codes used to track emerging technologies, services, and procedures for data collection purposes.
When reporting anesthesia services, which time unit formula is used for CMS?
Answer: (Base units + Time units) × Conversion factor
Anesthesia reimbursement is calculated as (Base Units + Time Units) × Conversion Factor, where time is typically reported in 15-minute increments.
Which modifier is used to indicate that a service was performed by a nurse practitioner or physician assistant acting as the primary provider?
Answer: -SA
Modifier -SA indicates that a service was performed by a nurse practitioner or physician assistant when acting as the primary non-physician provider.
HCPCS Level II codes are used primarily to report:
Answer: Supplies, equipment, non-physician services, and drugs not covered by CPT
HCPCS Level II codes cover supplies, durable medical equipment, drugs, ambulance services, and other non-physician services not found in CPT.