Test Your Modifiers Knowledge

Multiple Choice

1. Patient is seen in the office because of complications with his diabetes and thyroid. The doctor ordered lab work and performed a detailed history and examination. The patient also had a skin tag that he asked the doctor to remove from his neck and was bothersome. What modifier would be used for this office visit?

a. 25

b. 59

c. 51

d. 54


Patient presented to the office one week ago (gobal days are 10 days) with a skin lesion on her scalp. It was excised at that time and sent to the pathologist. The pathology report came back as malignant and she is here today for a re-excision for complete removal of the lesion. What modifier would be used for todays visit?

a. 24

b. 25

c. 58

d. None would be used

3. Patient came into the Urgen Care Facility for ankle swelling, discoloration and pain. Patient had a collision with another player at softball practice. A two view xray was taken by our xray technician and it confirmed a trimalleolar ankle fracture. The ankle was manipulated and a walking cast was applied. The patient is to return next week for a follow-up visit. The xrays were sent to the radiologist (who is not part of the Urgent Care Facility) for reading. What modifier would be used for this Urgent Care Visit?

a. TC

b. 26

c. 54

d. 58

4. Fifteen days ago the patient went to the Emergency Room for an ruptured appendix. The patient is here in my office today for redness and inflamation of his arm from a tattoo that he received a month ago. He has not had any vomiting or diarrhea. He has noticed some greenish color fluid coming from the inflammed area. He thinks he has a fever but did not take his temperature. Exam reveals skin of his arm is red, swelling and warm to touch. I have prescribed an antibiotic and he is to keep the area dry and apply neosporin 3 times per day. He did recently have his appendix removed but I do not believe it is related to his surgery. What modifier would the doctor use for this office visit?

a. 24

b. 25

c. 51

d. 79


This patient is from Nebraska and is visiting Yellow Stone National Park. He falls while hiking and the injury requires a open surgical fracture of his left humerus (code 23615). Surgery is performed by Doctor A. The patient is released two days later from the hospital and then seen by his home town doctor (Doctor B) in Nebraska for a post-op care. How are services billed by each Doctor A and Doctor B?

a. Doctor A 23615 for entire surgical package

b. Doctor A - 23615 - 54 Doctor B - 23615 -55

c. Doctor A - 23615 - 62 Doctor B - 23615 - 62

d. Doctor A - 23615 - 54 Doctor B - 23615 - 24

6. If the physician had to stop in the middle of a procedure because the patient’s blood pressure was dropping and they could not stabilize it, which modifier would you use?

a. 23

b. 52

c. 53

d. None would be used


Select the TRUE statement that defines per CPT why modifiers are reported?

a. Modifiers provides or indicates the procedure or service will be greatly increased in cost but not changed in its definition or code.

b. Modifier provides or indicates Evaluation and Management codes only have been altered but not changed in its definition or code.

c. Modifier provides or indicates procedure codes only have been altered but not changed in its definition or code

d. Modifier provides or indicates the service or procedure has been altered but not changed in its definition or code.

8. This Medicare patient is having laboratory work that Medicare will not reimburse the patient because the diagnosis does not support the test being ordered. The patient was informed Medicare will not pay, the patient signed the ABN and wanted the procedure performed. What modifier would be added to the laboratory code?

a. 52

b. 90

c. 92

d. GA


Per guidelines of proctosigmoidoscopy, sigmoidoscopy or colonoscopy which guideline is TRUE and correct?

a. Colonoscopy is the examination of the entire rectum, sigmoid colon and may include examination of a portion of the descending colon

b. Report flexible sigmoidoscopy (45378-45398) for endoscopic examination during which the endoscope is not advanced beyond the splenic flexure

c. If a therapeutic colonoscopy such as a 45380 is performed and does not reach the cecum or colon-small intestine anastomosis, report the appropriate therapeutic colonoscopy code with modifier 52.

d. When bleeding occurs as a result of an endoscopic procedure, control of bleeding is not reported separately during the same operative session.


Nurse is preparing the patient for his colonoscopy. Patient informs the nurse he has taken all steps necessary for his prep. The doctor performs the colonoscopy but after advancing the scope past the splenic flexure the physician must stop the procedure because the patient did not fully cleanse the large intestine and he is unable to continue the procedure. What modifier would be attached to the procedure?

a. 52

b. 53

c. 58

d. 76


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