General Surgery Coding Alert

See if you need to hone your modifier coding skills with this quiz.

Modifiers can make or break your claim. Leaving off a needed modifier or appending the wrong modifier can lead to denial after denial. So if your modifier knowledge isnt up to snuff, your practice could be missing out on major reimbursement.

Find out if youre using modifiers to properly code the services your surgeons perform with these five quiz questions. Turn to page 63 for the answers.

Question 1: Your surgeon performs a diagnostic endoscopy and, as a direct result of his findings, determines the need for an open surgical procedure. You know you can report the diagnostic endoscopy separately in this case. For Medicare, which modifier do you need to append to the open procedure code?

A. 58

B. 59

C. 78

D. 79.

Question 2: During an operative laparoscopic procedure, the surgeon determines that he must convert to an open procedure. You should report the open procedure code as well as the laparoscopic procedure code with modifier 53 appended.

A. True

B. False.

Question 3: A patient with a severe burn received an allograft skin graft 18 days ago. Now the patient is ready to have a partial thickness skin autograft applied as a final treatment. Which modifier should you use when you report the final treatment?

A. You dont need a modifier.

B. 58

C. 78

D. 79.

Question 4: Appending modifier 78 to a claim affects your reimbursement. Which of the following correctly explains how?

A. You should expect increased reimbursement.

B. You should expect reduced reimbursement.

C. You should expect normal fee reimbursement.

D. None of the above.

Question 5: The surgeon excises a lesion on the right hand and biopsies a different lesion on the patients left arm. Because of the separate sites, the excision and biopsy are separately billable. Which of the following modifiers do you need to accurately report this scenario?

A. 25

B. 26

C. 58

D. 59.