CPC Medicine Section and Modifiers 2

Question 1

What is the correct reporting for a vaccine administration with counseling for a child under 18?

Accepted Answer

90460 for first component, 90461 for each additional component

Answer

For patients under 18, vaccine administration with physician counseling uses 90460 for the first vaccine component and 90461 for each additional component.

Question 2

In physical medicine coding, what does 'therapeutic procedure' require compared to a 'modality'?

Accepted Answer

Therapeutic procedures require direct therapist interaction; modalities do not require constant attendance

Answer

Therapeutic procedures (e.g., therapeutic exercises) require direct, one-on-one therapist contact, whereas modalities such as hot packs may be supervised without constant attendance.

Question 3

Which modifier is used when a service or procedure is reduced or eliminated at the physician's discretion?

Accepted Answer

-52

Answer

Modifier -52 indicates a service was reduced in scope or eliminated at the physician's election, with documentation explaining the reduction.

Question 4

What does the -GY modifier signify in Medicare billing?

Accepted Answer

Item or service is statutorily excluded from Medicare coverage

Answer

Modifier -GY indicates that a service is statutorily excluded from Medicare or does not meet the definition of any Medicare benefit.

Question 5

Which psychiatry code is used to report add-on interactive complexity during a psychotherapy session?

Accepted Answer

90785

Answer

CPT 90785 is an add-on code for interactive complexity, reported with primary psychotherapy codes when communication factors complicate the session.

CPC - Certified Professional Coder Practice Test

CPC - Certified Professional Coder Practice Test

CPC Medicine Section and Modifiers 2