Medical Auditing Practice Exam

What does a procedure with an appended modifier indicate?

1. The procedure is newly defined with a different meaning.

2. The procedure performed was altered but the code definition remains unchanged.

3. The procedure is entirely separate from any other services provided.

4. The modifier was incorrectly applied to the procedure.

The correct answer is: The procedure performed was altered but the code definition remains unchanged.

A procedure with an appended modifier indicates that the procedure performed has been altered in some way while the fundamental definition of the code remains unchanged. Modifiers are used in medical coding to provide additional information about the procedure without changing the code itself. For instance, if a surgical procedure was performed on a specific area and there were certain circumstances that altered how the procedure was conducted—such as the need to perform it bilaterally or a more complex approach—using a modifier allows coders to convey this important context. Modifiers serve to clarify the specifics of the service without necessitating a completely new code, which is why the original intent and definition of the procedure remain intact even with the addition of the modifier. This is critical for ensuring accuracy in billing and reimbursement. Other options suggest changes in meaning, separate procedures, or incorrect usage, which do not accurately reflect what modifiers are intended to communicate in coding practice.