Medical coding - Modifiers Q & A - 4

The hospice patient, under hospice care for terminal COPD, falls out of bed and fractures his wrist. He is taken to the emergency department at the local hospital and has cast plication for the nondisplaced fracture. What modifier is reported to show that these services are not related to the patient’s hospice-qualifying condition?



a. Modifier GW.
Correct answer.

b. Modifier AT.
Incorrect answer. Modifier GW is specific for identifying services not related to a hospice

patient’s terminal condition.

c. Modifier GZ
Incorrect answer. Modifier GW is appropriate for reporting services that are not part of a patient’s terminal condition.

d. Modifier SC
Incorrect answer. Modifier GW is specific for identifying services not related to a hospice patient’s terminal condition.

HCPCS Level II modifiers can be used with which of the following code sets?

a. CPT codes
Incorrect answer. They can be used with both CPT and HCPCS Level II codes.

b. HCPCS Level II codes
Incorrect answer. They can be used with both CPT and HCPCS Level II codes.

c. ICD-9-CM volume III codes
Incorrect answer. They can be used with both CPT and HCPCS Level II codes, but not with ICD-9-CM procedure codes.

d. Both a and b.
Correct answer.

Modifiers G1 through G5, which report the levels of URR (Urea Reduction Ratio) in the blood, are reported with codes for ________________, and measure the efficacy of this modality.

a. Laboratory tests
Incorrect answer. They are reported with dialysis codes.

b. Dialysis codes.
Correct answer.

c. Coronary artery interventional procedures.
Incorrect answer. They are reported with dialysis codes.

d. Oxygen therapy.
Incorrect answer. They are reported with dialysis codes.

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