CPT code Modifiers

working_with_CPT_modifiers_worksheet.docx

HCR/201 v6

Working with CPT Modifiers Worksheet

HCR/201 v6

Page 2 of 2

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Working with CPT Modifiers Worksheet

Complete Parts A and B.

Part A

Resource: Table 5.2 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.)

Complete the exercise by identifying the correct Current Procedural Terminology (CPT) modifier to its corresponding procedure for the following:

· Bilateral procedures

· Multiple procedures

· Repeat clinical diagnostic laboratory test

· Unusual anesthesia

· Mandated services.

Part B

Resource: Ch. 5 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.)

Complete the following table.

Determine the correct modifier that would be used for billing.

Procedure	Modifier options
Patient had carpal tunnel surgery performed on both wrists.	56 32 47 50
Patient had a lumbar puncture at 01:00 with a repeat lumbar puncture at 05:00.	62 76 92 26
Professional component: reading radiology examination	26 25 22 99
Patient had an evaluation performed at the doctor’s office. After the evaluation, the doctor removed a lesion from the arm. Which modifier would be used to indicate a separate procedure for the lesion removal?	51 26 80 59
Patient had an evaluation performed at the doctor’s office. After the evaluation, the doctor removed a lesion from the arm. Which modifier could be used to signify a separate identifiable evaluation and management the same date of service as a procedure?	26 56 58 25
Patient had surgery last week and presents with a post-operative infection.	55 29 33 25
Patient had a mastectomy. Dr. Smith assisted Dr. James with the procedure. What modifier would be used to indicate the surgical assist code for Dr. Smith?	47 50 80 25
After having surgery, patient returned to the operating room later that day for uncontrolled bleeding.	80 26 53 78
A biopsy was removed and sent to an outside lab for pathology. Which modifier could be used to indicate outside laboratory?	92 22 91 90
Patient had an appendectomy and total hysterectomy performed during the same surgical episode. Which modifier would be used to indicate a multiple procedure performed for the appendectomy?	54 50 51 66