Fill in the Blank
Modifier ____ is used when only the technical component of a diagnostic test is performed.
What is TC
A patient is seen for a follow-up post-op visit for a hernia repair. On the same day, the physician evaluates and treats the patient for new onset asthma.
What is Modifier -25
Significant, separately identifiable E/M service on the same day
What is Modifier -25
Left side
What is Modifier -LT
A physician starts a colonoscopy but discontinues it due to poor prep. Which modifier would you use?
What is Modifier -53 (Discontinued procedure)
Modifier ____ indicates multiple procedures performed during the same session.
What is 51
A radiology group provides both the technical and professional components of an MRI of the brain. If the radiologist only interprets the test, which modifier should be appended to the CPT code?
What is Modifier 26
Distinct procedural service
What is Modifier -59
Right side
What is Modifier -RT
What’s the difference between modifier -26 and modifier -TC?
What is -26 = Professional component (physician’s work), -TC = Technical component (equipment, staff, facility)
If a physician performs an unrelated E/M service during a global period, use modifier ____.
What is 24
The surgeon removes a cyst from the left hand and a separate cyst from the right hand during the same session. Which modifiers might apply?
What is LT and RT
Multiple procedures
What is Modifier -51
Bilateral procedure
What is Modifier -50
A physician performs a laparoscopic appendectomy. Later in the global period, the same physician treats the patient for an unrelated broken arm.
What is Modifier -79 (Unrelated procedure during postop period)
Modifier ____ is applied for bilateral procedures.
What is 50
A patient undergoes a screening colonoscopy during which a polyp is found and removed. The screening service and the procedure are both reported. Which modifier should be used on the colonoscopy removal code to indicate it was converted from screening to diagnostic/therapeutic?
What is PT
Professional component only
What is Modifier -26
Unrelated E/M during the postoperative period
What is Modifier -24
A patient receives two different procedures at two different anatomical sites during one encounter. The payer requires clarification that these are distinct services.
What is Modifier -59 (Distinct procedural service)
Modifier ____ distinguishes procedures that are not normally reported together but are appropriate under the circumstances.
What is 59
A patient has a telehealth office visit conducted via real-time video. Which modifier should be appended?
What is 95
Technical component only
What is Modifier -TC
Telemedicine service
What is Modifier -95
Why do Modifiers matter ?
What is they ensure accurate reimbursement.