Question

Read the following case scenarios, and indicate the appropriate modifier 1. A patient is seen in the physician's office for his yearly physical (CPT code 99395). During the exam, the patient requests that the physician remove a mole on his shoulder What CPT modifier would be appended to the 99395 code to explain that the E/M service was unrelated to excision of the mole? 2. A patient is seen in a radiology clinic for an x-ray of the arm (CPT code 73090). The films were sent to another radiologist (not affmliated with the clinic) to interpret and write the report. What HCPCS Level II modifier would be appended to the CPT code for the services of the radiology clinic? 3. A surgeon performed an esophageal dilation (CPT code 43453) on a 4-week-old newborn who weighed 3.1 kg. What CPT modifier would be appended to the CPT code to describe this special circumstance? 4. A surgeon performed a tenolysis, extensor tendon of the right index finger (CPT code 26445). What HCPCS Level II modifier should be appended to the CPT code? 5. A planned arthroscopic meniscectomy of the knee was planned for a patient. During the procedure, the scope was nserted, but the patient went into respiratory distress and the procedure was terminated. What CPT modifier would be appended to the CPT code 29880 for the physician's services?

Answer 1

1. Modifier 25 is used for separate evaluation and management done on same day service.

2. Modifier TC for the technical component. Used when the procedure is done by one provider and interpretation is done by another provider.

3. Modifier 63 is used for the procedures done on infants who are under 4 kgs bodyweight.

4. Modifier F6 is used for the procedure done on the index finger of the right hand.

5. Modifier 53 is used for the discontinued procedure.