Coding Corner Question

Modifiers: The Key to Proper Reimbursement

Understanding how and when to use a modifier is a major key to coding. Modifiers will often determine if a charge is reimbursed or denied. Take this quiz to discover how well you understand modifiers.

1. A 60-year-old female patient comes in for a follow-up visit for her RA. During the visit, the patient complains of severe swelling in her left knee. The rheumatologist performs a level-three office visit and makes the decision to perform a joint injection on the knee. How would this be coded?
   1. 99213, 20610-25
   2. 99213-25, 20610-25
   3. 99213-25, 20610-LT
   4. 99213, 20610-LT
2. An established 56-year-old male patient comes in for his scheduled visit for the third in the series of four joint injections for osteoarthritis of the knees. The rheumatologist gives the patient a joint injection in the right knee. How would this be coded?
   1. 99212, 20610-RT
   2. 99212-25, 20610-RT
   3. 20610-RT
   4. None of the above
3. A 38-year-old male patient returns to the rheumatologist’s office for scheduled infliximab infusion. Thirty-four minutes into the infusion, the patient has an adverse reaction to the drug. The IV line is flushed with saline and the patient is given methylprednisolone sodium succiante. The infusion is discontinued. How would this be coded?
   1. 96413, 96360, 96374
   2. 96413, 96361-59, 96375
   3. 96413, 96361-59, 96374
   4. 96413, 96360-59, 96374
4. An established 56-year-old female patient comes in for her scheduled visit for the third in a series of four joint injections for osteoarthritis of the knees. The rheumatologist gives the patient a joint injection in each knee. How would this be coded?
   1. 20610-50
   2. 20610-LT, 20610-RT
   3. 20610, 20610-50
   4. All of the above
5. An established 28-year-old female patient comes in for her scheduled methotrexate injection. The nurse takes her vitals and administers the injection. How would this be coded?
   1. 99211-25, 96401
   2. 96401
   3. 99211-25, 96372
   4. 96372

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