CPCA Modifier Use in Dermatology 2

Question 1

A dermatologist performs a shave removal of a benign lesion on the back and, during the same session, destroys a premalignant actinic keratosis on the forearm. Which modifier is appended to the destruction code?

Accepted Answer

Modifier 51

Answer

Modifier 51 is used when multiple procedures are performed during the same operative session by the same physician.

Question 2

When a physician performs a biopsy and then a more definitive excision of the same lesion during the same encounter, which modifier allows separate billing for the biopsy?

Accepted Answer

Modifier 59

Answer

Modifier 59 indicates a distinct procedural service, allowing the biopsy to be billed separately from the excision performed at the same encounter.

Question 3

A patient has a malignant melanoma excised with a 2 cm margin from the right cheek. The surgeon also excises a basal cell carcinoma from the left cheek during the same session. What modifier is added to the second excision code?

Accepted Answer

Modifier 51

Answer

Modifier 51 is appended to the secondary procedure to indicate multiple procedures were performed at the same session.

Question 4

Modifier 52 is used in dermatology coding when:

Accepted Answer

A procedure is performed at a reduced level of service

Answer

Modifier 52 indicates that a service or procedure was partially reduced or eliminated at the physician's discretion.

Question 5

A dermatologist excises a squamous cell carcinoma from the scalp and repairs the wound with an adjacent tissue transfer. How should the repair be billed?

Accepted Answer

Bill separately without a modifier

Answer

Adjacent tissue transfer or rearrangement repairs are separately billable from excision codes without an additional modifier because they are not considered bundled services.

CPCA Exam Practice Test

CPCA Exam Practice Test

CPCA Modifier Use in Dermatology 2