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Question 1
What is the primary purpose of a CPT modifier?
Answer: A modifier provides additional information to indicate that a service was altered in some way without changing the definition of the code, allowing for separate reimbursement when appropriate.
Question 2
What does modifier -26 indicate when appended to a CPT code?
Answer: Modifier -26 indicates the professional component only — the physician's interpretation and report — was performed, separate from the technical component.
Question 3
What does modifier -TC indicate when appended to a diagnostic code?
Answer: Modifier -TC (Technical Component) indicates that only the technical portion of the service — equipment, staff, and supplies — was provided, not the physician's interpretation.
Question 4
What does modifier -52 indicate, and how does it differ from modifier -53?
Answer: Modifier -52 indicates a reduced service performed electively by the physician before completion. Modifier -53 indicates a procedure discontinued after administration of anesthesia due to extenuating circumstances or patient risk.
Question 5
What is the function of modifier -22 (Increased Procedural Services)?
Answer: Modifier -22 is appended when the work required to perform a procedure is substantially greater than typically required, and it usually requires documentation and may result in additional reimbursement.