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WorksheetsApril 2025
Total questions: 50
Worksheet time: 25mins
Which modifier indicates a significant, separately identifiable E/M service on the same day?
-25
-59
-51
-24
Modifier -59 is used to indicate:
Services unrelated to diagnosis
Procedures on different days
Distinct procedural service
Global care only
Modifier -50 refers to:
Right side
Bilateral procedure
Multiple visits
Post-op care
Use modifier -26 for:
Full service
Technical component
Professional component
Incomplete service
Modifier -58 is used for:
Unrelated procedures
Staged or related procedure during global period
Assistant at surgery
Bilateral surgery
A patient returns to the OR for post-op bleeding. Which modifier?
-25
-59
-78
-52
Modifier -91 applies to:
Physical therapy
Repeat clinical lab test
Diagnostic ultrasound
Consultation
CPT® codes for anesthesia are found in what range?
10021–69990
70010–79999
00100–01999
80047–89398
HCPCS Level II codes that start with J describe:
Ambulance services
Radiology
Medications and injections
Surgery
In ICD-10-CM, diabetes is coded under:
E08–E13
I10–I15
R50–R69
F01–F99
Modifier -LT refers to:
Bilateral procedure
Left side
Emergency care
Right side
Which code set is used for diagnoses?
CPT®
ICD-10-CM
HCPCS Level II
NDC
Modifier -GC is used to show:
Cosmetic surgery
Services under teaching physician supervision
Technical component only
Multiple surgeries
The CPT® section for radiology services is:
00100–01999
10021–69990
70010–79999
90000–99999
HCPCS Level II ambulance services start with which letter?
A
G
T
J
Modifier -24 is used for:
Same procedure repeated
Unrelated E/M during post-op
Preventive care
Global period
Which CPT® modifier refers to increased procedural services?
-77
-76
-22
-55
Where are E/M codes located in the CPT® manual?
Back
Medicine section
Surgery section
99202–99499
Modifier -52 is used for:
Repeat test
Reduced services
Repeat procedure by same provider
Right side
ICD-10-CM codes always start with:
Numbers
Letters
Modifiers
Symbols
CPT® Category II codes are:
Mandatory
Optional performance tracking
HCPCS temporary codes
Surgery codes
The CPT® index helps locate codes based on:
Diagnosis
Procedure name
Body part
Insurance payer
CPT® modifier -PT is used to show:
Partial service
Diagnostic converted from preventive
Teaching physician
Repeat test
Modifier -Q6 is used when:
CRNA is on staff
Locum tenens is used
Teaching physician is present
Routine foot care
What does modifier -AS represent?
Assistant surgeon
Amputation service
Ambulatory setting
Advance screening
Modifier -P3 refers to:
Pregnancy
High-risk anesthesia
Post-op care
New patient
Modifier -RT refers to which side?
Left
Right
Bilateral
Not applicable
Where are vaccine codes found in CPT®?
Radiology
Pathology
Medicine
Surgery
The ICD-10-CM Tabular List is organized by:
Procedure type
Code chapter
Diagnosis order
Alphabet
CPT® updates are released:
Monthly
Quarterly
Annually
Every 5 years
The prefix tachy- means:
Slow
Normal
Fast
Below
The suffix -ectomy means:
Disease
Inflammation
Surgical removal
Flow
The root nephr/o refers to the:
Liver
Kidney
Stomach
Skin
The suffix -dynia means:
Flow
Swelling
Pain
Abnormal
The prefix sub- means:
Above
Beyond
Under
Beside
Cardi/o is the root for:
Brain
Kidney
Liver
Heart
The suffix -rrhea means:
Bleeding
Discharge or flow
Infection
Inflammation
Hepat/o refers to which organ?
Lung
Liver
Heart
Brain
The suffix -logy means:
Study of
Tumor
Pain
Removal
What does the prefix hyper- mean?
Below
Around
Excessive
Under
What is the most common reason for claim denials?
Incorrect demographics
Unbundled services
Missing diagnosis code
Lack of medical necessity
What should be your first step when a claim is denied?
Delete it
Appeal
Review EOB and documentation
Resubmit as is
What is an Explanation of Benefits (EOB)?
A medical report
A legal form
A document showing how a claim was processed
A denial notice
Which type of denial occurs when procedures are coded together instead of separately?
Prior auth
Duplicate claim
Bundling denial
Non-covered service
If a claim is denied for "timely filing," what does it mean?
The service was not covered
The claim was submitted after the allowed period
The provider forgot the diagnosis
The modifier was wrong
What does "medical necessity" mean?
Patient requested it
Covered by insurance
Reasonable and required for diagnosis or treatment
Performed in hospital
Which code link is necessary to justify a procedure?
CPT® only
ICD-10 only
Diagnosis linked to service
Modifiers
What is an appeal?
A request to resend a bill
A new insurance claim
A request for reconsideration of a denied claim
Claim deletion
What should you do if documentation does not match the services billed?
Submit anyway
Correct documentation or coding
Use a default modifier
Bill the patient
What is the best strategy to reduce claim denials?
Skip modifiers
Submit manually
Use templates for all patients
Accurate documentation and coding review
