Oncology & Hematology Coding Alert

And refresh your memory of these modifier functions.

Sometimes in the process of treating a patient, oncologists have to repeat procedures or tests, or perform necessary related procedures, for legitimate reasons. Perhaps the first test results were baseline, and the provider must perform the test again to assess progression. Maybe the protocol for treating a patient calls for performing the procedure a second time to assess signs of effectiveness. Or perhaps an initial surgery needs following up due to unintended consequences.

When this happens, you know you have to append a modifier to the appropriate CPT^® code to indicate to a payer that repeating the service, or performing an additional, related service, was intentional and medically necessary. But which modifier do you append to indicate the charge is not an unintended duplicate?

The last three questions in this quiz will help you understand which modifier to use in these circumstances. But first, let’s make sure you understand what a modifier actually does when you append it to the procedure code.

Question 1: According to CPT^®, what is the function of a modifier?

Question 2: When do you append modifier 79, and how does it differ from modifiers 76 and 77?

Question 3: When do you append modifier 78?

Question 4: When do you append modifier 58?

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