AAPC Certified Professional Coder (CPC) — All Questions

The same surgeon performs several distinct surgical procedures through separate incisions during one operative session. Which modifier identifies the second and subsequent procedures so the payer can apply the multiple-procedure fee reduction?

• a.Modifier -59 (Distinct procedural service)
• b.Modifier -22 (Increased procedural services)
• c.Modifier -51 (Multiple procedures)✓
• d.Modifier -50 (Bilateral procedure)

Modifier -51 tells the payer that more than one procedure was performed in the same session by the same provider, so payment ranking (100% for the highest-valued, reduced for the rest) can be applied. -50 is only for mirror-image bilateral procedures, -59 unbundles services that are normally packaged together, and -22 signals substantially greater work than usual. Do not confuse the multiple-procedure concept (-51) with unbundling (-59).

When selecting a CPT code for excision of a benign skin lesion, how is the size determined?

• a.The diameter of the lesion alone, ignoring surgical margins
• b.The greatest clinical diameter of the lesion plus the narrowest margin required, measured before excision✓
• c.The total surface area of skin removed, including the repair
• d.The diameter of the specimen as measured by pathology after fixation

Excised diameter equals the lesion's greatest clinical diameter plus the most narrow margins needed on each side, and it must be measured before removal because formalin fixation shrinks tissue. Coding from the pathology report understates the true size. Margins are part of excision sizing, and the closure (repair) is coded separately when it rises to intermediate/complex.

A CPT surgical code carries the parenthetical designation '(separate procedure).' What does this tell the coder?

• a.It is never reimbursable under any circumstance
• b.The procedure is always billed separately in addition to any other service; a '(separate procedure)' designation guarantees independent payment, telling the coder to report it on its own line alongside the primary procedure regardless of whether it was integral to that larger service
• c.It always requires modifier -50
• d.It is bundled when performed as an integral part of a larger procedure, but may be reported when it is the only service or is unrelated/distinct✓

'Separate procedure' means the service is considered an inherent component of a more comprehensive procedure and is not billed when performed at the same site/session as that larger procedure. It becomes reportable only when performed alone or on a different site/session — often supported by modifier -59 or an appropriate X{EPSU} modifier.

For a major surgery with a 90-day global period, which of the following is INCLUDED in the global surgical package and NOT separately reportable?

• a.Treatment of an unrelated new illness during the postoperative period
• b.A staged or planned return to the operating room decided in advance
• c.Diagnostic tests and studies needed to establish the surgical diagnosis; the global surgical package absorbs all preoperative work-up, so imaging and laboratory studies ordered to confirm the need for surgery are bundled into the procedure and not separately reportable
• d.The operation, the related preoperative E/M on the day before or day of surgery, and routine postoperative care during the 90 days✓

The global package bundles the procedure itself, the related pre-op visit the day before/of surgery, intraoperative work, and normal follow-up care through the global window. Unrelated care (modifier -24/-79), staged procedures (-58), and the diagnostic work-up that led to the decision for surgery fall outside the package and are separately payable.

What distinguishes an 'intermediate' wound repair from a 'simple' repair in CPT?

• a.Intermediate repair requires layered closure of one or more deeper layers (subcutaneous tissue/superficial fascia) in addition to the skin, or single-layer closure of a heavily contaminated wound needing extensive cleaning✓
• b.Intermediate repair is defined by the use of staples instead of sutures; the CPT repair classification turns entirely on the closure material chosen, so any wound closed with staples, adhesive strips, or tissue glue is automatically intermediate no matter how many skin layers were involved or how clean the wound was
• c.Intermediate repair is any laceration longer than 2.5 cm
• d.Intermediate repair always includes debridement down to bone

Repair (closure) codes are grouped as simple, intermediate, or complex. Simple is a one-layer closure of superficial wounds. Intermediate requires layered closure of deeper subcutaneous tissue/superficial (non-muscle) fascia in addition to the skin, or single-layer closure of a wound so contaminated it needs extensive cleaning/foreign-body removal. Complexity is about the layers and work involved, not simply length or the closure material.

A provider performs several wound repairs that are all the same classification (e.g., all intermediate) and fall within the same anatomic-site grouping listed in CPT. How are they reported?

• a.Add the lengths of the repairs together and report one code for the summed length✓
• b.Report each repair as a separate line with modifier -51 regardless of location
• c.Report only the single longest repair and disregard the others
• d.Report only the shortest repair

CPT instructs coders to sum the lengths of repairs that are in the SAME classification AND the SAME anatomic-site grouping, then report a single code for that combined length. Repairs of different classifications, or in different anatomic groupings, are reported separately (the more complex listed first, others with modifier -59 as appropriate). This summation rule prevents both under- and over-reporting of laceration repairs.

During the postoperative global period, the patient must be taken back to the operating room for an unplanned procedure to treat a complication of the original surgery. Which modifier applies to that return trip?

• a.-79 (unrelated procedure by the same physician during the postoperative period)
• b.-78 (unplanned return to the operating/procedure room for a related procedure)✓
• c.-76 (repeat procedure by the same physician, used when an identical service is simply repeated)
• d.-58 (staged or related procedure planned prospectively at the time of the original surgery)

Modifier -78 reports an UNPLANNED return to the OR/procedure room during the global period for a problem related to the first surgery (typically a complication). It is distinct from -58 (something planned or staged in advance), -79 (a completely unrelated procedure), and -76 (a simple repeat of the same service, not a return to the OR). Choosing -78 correctly signals a related, unplanned reoperation.

At the time of the initial surgery, the surgeon documents that a second, more extensive procedure will be performed in stages during the global period. Which modifier is appended to the later staged procedure?

• a.-24 (unrelated E/M during the postoperative period)
• b.-58 (staged or related procedure/therapy planned prospectively)✓
• c.-79 (unrelated procedure)
• d.-78 (unplanned return for a complication)

Modifier -58 identifies a procedure during the global period that was planned or anticipated (staged), is more extensive than the original, or is therapy following a diagnostic procedure. The key is that it was prospectively planned — unlike -78, which is an unplanned return for a complication. Sequencing modifiers correctly protects reimbursement for legitimately staged care.

Two surgeons of different specialties each act as a primary surgeon, performing distinct parts of the same operative procedure. Which modifier does each surgeon append?

• a.-62 (two surgeons / co-surgeons)✓
• b.-82 (assistant surgeon when a qualified resident is unavailable)
• c.-66 (surgical team, used when a team of surgeons is required for one highly complex procedure)
• d.-80 (assistant surgeon actively assisting the primary surgeon throughout the procedure)

Modifier -62 is used when two surgeons work together as co-surgeons, each performing a distinct portion of the same procedure and each reporting the same code with -62. This differs from an assistant (-80/-81/-82), who helps a single primary surgeon, and from a surgical team (-66), which involves several physicians and other highly specialized personnel.

A second physician actively assists the primary surgeon throughout an operation in a non-teaching setting. Which modifier reports the assistant surgeon's service?

• a.-62 (co-surgeons)
• b.-80 (assistant surgeon)✓
• c.-81 (minimum assistant surgeon)
• d.-82 (assistant surgeon when a qualified resident surgeon is not available)

Modifier -80 is the standard assistant-surgeon modifier for a physician who assists throughout the procedure. -81 reports minimal assistance for part of the procedure, and -82 is specific to teaching hospitals where a qualified resident surgeon was not available. Matching the assistant scenario to the right modifier (-80 vs -81 vs -82) is a common CPC test point.

When a surgical endoscopy is performed, how is the diagnostic endoscopy of the same anatomic site handled?

• a.It replaces the surgical endoscopy code
• b.It is reported separately with modifier -59
• c.It is bundled into the surgical endoscopy and is not separately reportable✓
• d.It is always reported separately with modifier -51

A surgical endoscopy always includes the diagnostic endoscopy of the same site — you cannot operate endoscopically without first visualizing the area. Therefore the diagnostic scope is bundled into the surgical scope and is not separately billable. This is a specific application of the broader rule that a diagnostic procedure inherent to a therapeutic one is not reported separately.

A surgeon excises two separate benign lesions at two different anatomic sites during one operative session. How is this reported?

• a.A separate excision code for each lesion, sized individually, with an appropriate distinct-service modifier when required✓
• b.A single code representing the combined diameter of both lesions; when two lesions are excised at different sites their greatest diameters are added together and reported under one excision code sized to that total, rather than coding each lesion on its own line
• c.One code for the largest lesion only, with the smaller lesion considered incidental to the same operative field and not separately reportable
• d.One excision code with modifier -50

Lesion excisions are reported per lesion — each excision is sized by its own greatest clinical diameter plus narrowest margins and coded individually. You never add two lesions' diameters together, and -50 (bilateral) applies only to mirror-image paired structures, not to two unrelated lesions. Modifier -59 or an anatomic modifier may be needed to show the lesions are distinct.

Modifier -51 (multiple procedures) should NOT be appended to which of the following?

• a.Every procedure performed in the same session
• b.Bilateral procedures
• c.Codes reported from the radiology section
• d.Add-on codes and codes designated as modifier -51 exempt✓

Add-on codes (which by definition describe additional work performed with a primary procedure) and codes flagged as modifier -51 exempt are never appended with -51 — they are already valued to be reported in addition to the primary service and are not subject to the multiple-procedure fee reduction. Applying -51 to these codes is an error CPT specifically warns against.

Does closed treatment of a fracture WITHOUT manipulation carry a global surgical package (a global period)?

• a.Only if the patient is admitted as an inpatient
• b.No — without manipulation there is no procedure, so it is coded only as an E/M visit
• c.Only when a cast is applied by an orthopedic surgeon
• d.Yes — fracture care codes include a global period and bundle routine follow-up care whether or not manipulation was performed✓

Fracture care (restorative treatment) codes are 'surgical' codes with global periods even when no manipulation or incision occurs. Reporting fracture care commits you to the global package — the initial casting/strapping and normal follow-up visits are included. Alternatively, a provider may choose E/M plus casting/supply codes, but the two approaches should not be double-billed.

The anatomical directional term 'distal' means:

• a.Nearer to the point of origin, the trunk, or the central attachment of the structure
• b.Farther from the point of origin or attachment✓
• c.Toward the front or anterior surface of the body, away from the back
• d.Toward the midline or median plane of the body, as the term medial denotes

Distal = farther from the point of origin/attachment (the fingers are distal to the wrist), whereas proximal = nearer the origin. Anterior/ventral is toward the front and medial is toward the midline. The trap is distal versus proximal, which describe opposite ends of a limb or structure.

Which anatomical plane divides the body into anterior (front) and posterior (back) portions?

• a.Sagittal plane, which divides the body into right and left portions along its length
• b.Transverse (axial) plane
• c.Midsagittal plane, splitting the body into equal left and right halves
• d.Coronal (frontal) plane✓

The coronal (frontal) plane divides the body into anterior and posterior sections. The sagittal plane divides it into right and left, and the transverse (axial) plane divides it into superior and inferior. The trap is coronal versus sagittal — front/back versus left/right — a common anatomy test point.

In CPT musculoskeletal coding, 'closed treatment' of a fracture means:

• a.The fracture is always displaced
• b.A cast is never applied
• c.The bone ends are visualized through a surgical incision; 'closed treatment' in CPT musculoskeletal coding refers to the surgical exposure achieved, so any fracture care in which the provider directly sees the fracture site — even briefly through a small opening — is classified as closed rather than open
• d.The fracture site is not surgically opened/exposed — it describes the treatment approach (which may still include manipulation), not whether the skin or bone is broken✓

Closed, open, and percutaneous describe the treatment approach: 'closed treatment' means the fracture site is not surgically opened to view, though the provider may still perform manipulation or apply traction. The trap is confusing an 'open fracture' (skin broken over the bone) with 'open treatment' (surgical exposure of the fracture) — different concepts entirely.

In vascular catheterization coding, a 'selective' catheter placement means:

• a.The catheter stays in the vessel that was punctured; a 'selective' placement describes a catheter that remains within the initially accessed vessel without advancing into any branch, distinguishing it from a nonselective study reaching into the vascular family
• b.No contrast is injected
• c.The catheter is manipulated/advanced into a branch beyond the vessel first accessed (into the vascular family)✓
• d.The catheter remains in the aorta only and is never advanced past the origin of any branch vessel, which defines a selective study

Selective catheterization means the catheter is guided and manipulated past the access site into a branching vessel (an order within the vascular family), whereas nonselective placement keeps the catheter in the punctured vessel or the aorta. The trap is options A and D, which describe nonselective placements — coding the two the same overstates or understates the work.

The global obstetric (maternity) package for routine care typically bundles:

• a.Antepartum care, the delivery, and postpartum care combined into one global service✓
• b.Only the delivery itself, with all antepartum and postpartum visits reported separately as individual services
• c.Only the prenatal (antepartum) visits, with the delivery and postpartum care billed separately each time
• d.The delivery plus newborn care rendered to the infant after birth, excluding the mother's prenatal visits

The routine maternity global package includes antepartum care, the delivery itself, and postpartum care. Complications or unrelated problems are reported separately, and newborn care is a separate service to the infant. The trap is coding delivery-only when the same provider furnished the full spectrum of routine maternity care.

When coding a lower-GI endoscopy, the choice between a flexible sigmoidoscopy and a colonoscopy code depends on:

• a.The patient's age
• b.Whether sedation was used
• c.Whether a biopsy was taken during the procedure, because CPT separates flexible sigmoidoscopy from colonoscopy solely on whether tissue was sampled — a scope advanced all the way to the cecum is still coded as a sigmoidoscopy when no biopsy is obtained
• d.How far the endoscope is advanced (a colonoscopy passes beyond the splenic flexure, while a flexible sigmoidoscopy is limited to the sigmoid/descending colon)✓

The extent to which the scope is advanced determines the code: a colonoscopy examines the colon beyond the splenic flexure (and may reach the cecum), while a flexible sigmoidoscopy is limited to the sigmoid and descending colon. A colonoscopy that cannot be advanced past the flexure is coded as a sigmoidoscopy or with a reduced/discontinued modifier. The trap is coding by biopsy or sedation rather than extent.

Mohs micrographic surgery codes may be reported only when:

• a.Two different physicians share the surgery and the pathology; Mohs codes specifically require a surgeon to remove the tissue and a separate pathologist to read the stages, so a single physician performing both roles is barred from reporting the Mohs code
• b.The specimen is sent to an outside laboratory for reading
• c.Only benign lesions are involved
• d.A single physician acts as BOTH the surgeon and the pathologist, performing the excision and the microscopic examination of the stages✓

Mohs surgery codes require one physician to serve in two integrated roles — surgeon and pathologist — excising tissue in stages and personally examining the mapped specimens microscopically. If a separate pathologist interprets the specimen, Mohs codes do not apply; the excision and pathology are reported separately instead. The trap is using Mohs codes when the pathology is done by someone else.

A surgeon performs a diagnostic arthroscopy of the knee and then proceeds to a surgical arthroscopy of the same knee. The diagnostic arthroscopy is:

• a.Reported separately with modifier -51
• b.Bundled into the surgical arthroscopy and not separately reportable✓
• c.Reported separately with modifier -50
• d.Reported instead of the surgical arthroscopy

As with other endoscopic procedures, a surgical arthroscopy includes the diagnostic arthroscopy of the same joint — you cannot operate arthroscopically without first visualizing the joint. The diagnostic scope is therefore bundled and not billed separately. The trap is unbundling the diagnostic arthroscopy with -51 or -50 when it is inherent to the surgical procedure.

Excisional debridement CPT codes are selected primarily by:

• a.The depth of viable tissue removed (e.g., subcutaneous vs muscle/fascia vs bone) and the total surface area debrided✓
• b.The number of surgical assistants present and the total operative time they spend at the bedside, which together set the code level
• c.The anesthesia used
• d.The type of dressing applied afterward; excisional debridement codes are selected by the wound-care product used to dress the site — an alginate, hydrocolloid, or negative-pressure dressing — rather than by the depth of tissue removed or the surface area treated

Debridement codes are leveled by the deepest layer of tissue removed (skin/subcutaneous, muscle/fascia, or bone) and by the surface area treated, with add-on codes for additional area. The trap is coding by wound size alone, or ignoring the documented depth, which is the primary driver of code selection.

In burn and skin-replacement coding, the 'rule of nines' is used to:

• a.Estimate the percentage of total body surface area (TBSA) involved, which drives burn/graft code selection✓
• b.Count the number of individual skin grafts used, since each graft adds a fixed increment to the code selection
• c.Determine the anesthesia time
• d.Measure a single lesion's diameter; the rule of nines is a lesion-sizing tool that converts a wound's longest dimension into a standardized graft measurement, and it is unrelated to estimating the percentage of total body surface area burned

The rule of nines estimates the percentage of total body surface area affected by dividing the body into regions worth roughly 9% (or multiples). Burn treatment and skin-substitute codes depend on the extent (% TBSA) and depth of involvement. The trap is confusing TBSA percentage with the single-lesion diameter method used for lesion excisions.

Cataract extraction performed with insertion of an intraocular lens (IOL) in the same session is generally reported as:

• a.Two separate codes, one for the extraction and one for the lens
• b.An E/M service
• c.A single code that includes both the cataract extraction and the intraocular lens insertion✓
• d.A radiology code

Cataract removal with IOL insertion is a single, comprehensive procedure code that already includes placing the lens prosthesis in the same operative session. The trap is unbundling the IOL insertion onto a separate line when the extraction-with-lens code already accounts for it.

For spinal (epidural/paravertebral) injection coding, a key determinant of code selection is:

• a.The patient's weight
• b.The color of the contrast
• c.The referring provider's specialty; spinal injection code selection is driven by whether a pain-management, orthopedic, or neurosurgical physician ordered the block, and neither the vertebral region nor the transforaminal-versus-interlaminar approach affects which code is finally reported
• d.The spinal region/level and the injection approach (e.g., transforaminal vs interlaminar), plus the applicable imaging-guidance bundling rules✓

Spinal injection codes are chosen by the anatomic region/level (cervical/thoracic vs lumbar/sacral) and the specific approach or target (for example, transforaminal versus interlaminar epidural), and many of these codes bundle the imaging guidance when performed. The trap is being distracted by irrelevant factors such as patient weight or referring specialty.

Like other endoscopic procedures, a surgical bronchoscopy code:

• a.Excludes any diagnostic examination entirely, so a separate diagnostic bronchoscopy must always be reported alongside it
• b.Includes the diagnostic bronchoscopy performed at the same session, which is not separately reportable✓
• c.Requires modifier -50 whenever the bronchoscope examines both the right and left bronchial trees in the same session
• d.Is billed as an E/M service

A surgical bronchoscopy includes the diagnostic bronchoscopy of the same session, because visualization is inherent to performing the therapeutic work. The diagnostic scope is therefore bundled and not separately reported. The trap is unbundling the diagnostic bronchoscopy, a recurring endoscopy-coding error.

An obstetrician performs the delivery and provides postpartum care, but the patient's antepartum care was provided entirely by a different practice. The obstetrician should report:

• a.The full global obstetric package; because the same obstetrician performed the delivery and the postpartum care, the global maternity code is reported in its entirety even though the antepartum care came from an unrelated practice, and no reduction for the missing component is taken
• b.An E/M code only
• c.The code describing delivery including postpartum care (the global package is not used because antepartum care was provided elsewhere)✓
• d.Antepartum care only

The global maternity package applies only when the same provider/group furnishes all three components (antepartum, delivery, postpartum). When a provider renders only part of the care, they report the portion actually performed — here, delivery-with-postpartum-care. The trap is reporting the full global package for care the provider did not entirely deliver.

When choosing between the benign and malignant lesion-excision code families, the coder should base the choice on:

• a.The pathologic diagnosis (benign vs malignant), together with the excised size and site✓
• b.The surgeon's pre-operative clinical impression only
• c.The number of sutures used
• d.The anesthesia type

Lesion-excision code selection depends on whether the pathology report confirms the lesion as benign or malignant, plus the excised diameter (lesion + narrowest margins) and the anatomic site. Coders should wait for the pathology result before assigning a malignant code. The trap is coding a malignant excision from the surgeon's clinical impression before pathology confirms malignancy.

A physician electively performs only part of a planned procedure — the service was partially reduced at the physician's discretion, without endangering the patient. Which modifier applies?

• a.-22 (increased procedural services)
• b.-53 (discontinued procedure due to patient risk)
• c.-74 (facility discontinued after anesthesia)
• d.-52 (reduced services)✓

Modifier -52 reports a service that was partially reduced or eliminated at the provider's discretion when the patient's safety was not at issue. It differs from -53 (the provider terminates a started procedure because of a threat to the patient's well-being) and from the facility/ASC modifiers -73/-74. The trap is -52 versus -53 — elective reduction versus a safety-driven stop.

A colonoscopy is terminated after sedation is administered because the patient becomes hemodynamically unstable. The physician reports the discontinued procedure with:

• a.-52 (reduced services)
• b.-59 (distinct procedural service)
• c.-53 (discontinued procedure)✓
• d.-73 (facility discontinued before anesthesia)

Modifier -53 reports a procedure the physician elected to terminate after it began (often after anesthesia/sedation) because of a threat to the patient's well-being. It contrasts with -52 (a planned partial reduction not driven by patient risk) and with the facility/ASC modifiers -73/-74. The trap is -53 versus -52 — a safety-driven stop versus an elective reduction.

Modifier -63 is appended to certain procedures performed on:

• a.Neonates and infants with a present body weight up to 4 kg, reflecting significantly increased work✓
• b.Patients over age 70
• c.Any pediatric patient under the age of eighteen, regardless of the child's current documented body weight
• d.Patients with obesity whose elevated body mass index is documented as increasing the procedural work and time

Modifier -63 identifies procedures on neonates and infants with a present body weight up to 4 kg, acknowledging the significantly greater complexity and risk of operating on very small patients. The trap is applying -63 to all pediatric patients; it is restricted by weight (and excluded on certain codes that already account for small size).

A service that is required by a third-party payer (for example, a mandated second opinion) is reported with:

• a.-25 (significant, separately identifiable E/M)
• b.-32 (mandated services)✓
• c.-57 (decision for surgery)
• d.-52 (reduced services)

Modifier -32 indicates a service that was mandated by a third party — such as a payer-required second or third opinion — as opposed to one requested by the patient or family. The trap is confusing a mandated service (-32) with a patient-initiated visit or with the E/M modifiers -25/-57, which address different scenarios.

A procedure is performed on both the right and left sides of a paired structure in the same session, and the code is eligible for bilateral reporting. The standard way to report is:

• a.A single procedure line with modifier -50 (bilateral), per payer convention✓
• b.Two separate procedure lines, each reported with modifier -51 to indicate multiple procedures in the session
• c.Modifier -59 on a second procedure line to unbundle the contralateral side as a distinct service
• d.Modifier -76 on a second procedure line to report the contralateral side as a repeat

For a bilateral-eligible code, modifier -50 reports that the procedure was performed on both sides, typically on one line (payers vary on units/pricing). The trap is using -51 (multiple procedures), -59 (distinct service), or -RT/-LT on two lines when -50 is the appropriate bilateral indicator — improper reporting can cut payment or trigger denials.

The anatomical directional term 'proximal' means:

• a.Toward the midline of the body
• b.Farther from the point of attachment
• c.Toward the surface of the body
• d.Nearer to the point of origin or attachment to the trunk✓

'Proximal' means closer to the trunk or origin; 'distal' means farther away (the wrist is distal to the elbow). 'Medial' refers to the midline and 'superficial' to the surface. Precise directional terms are essential for reading operative notes and assigning site-specific codes.

The terms 'medial' and 'lateral' describe position relative to:

• a.The front and back of the body
• b.The midline of the body (medial = toward it, lateral = away from it)✓
• c.The surface and interior
• d.The head and feet

'Medial' is toward the midline and 'lateral' is away from it. Anterior/posterior describe front/back, superior/inferior describe head/feet, and superficial/deep describe surface/interior. Mixing these axes is a common anatomy error.

The sagittal plane divides the body into:

• a.Right and left portions✓
• b.Internal and external portions
• c.Upper and lower portions
• d.Front and back portions

The sagittal (median when midline) plane separates right and left. The transverse (horizontal) plane divides upper/lower, and the coronal (frontal) plane divides anterior/posterior. Plane terminology recurs in radiology and anatomy questions.

The abdominopelvic region is commonly divided for clinical description into:

• a.Twelve segments matching the ribs
• b.Two halves only
• c.Six cavities
• d.Four quadrants (RUQ, LUQ, RLQ, LLQ) or nine regions✓

Clinicians localize abdominal findings using four quadrants or the more detailed nine-region scheme (e.g., epigastric, umbilical, hypogastric). Accurate localization supports correct anatomic code selection and matching the diagnosis to the site.

A patient positioned lying face-up is described as:

• a.Supine✓
• b.Prone
• c.Lateral
• d.Fowler's

'Supine' = lying face-up; 'prone' = face-down; 'lateral' = on one side; 'Fowler's' = semi-sitting. Positioning terms appear in operative and procedure notes and can affect approach-specific coding.

A surgeon performs only the operative (intraoperative) portion of a procedure and transfers postoperative care to another physician. The operating surgeon reports the surgical code with:

• a.Modifier -54 (surgical care only)✓
• b.Modifier -56 (preoperative management only)
• c.Modifier -62 (two surgeons)
• d.Modifier -55 (postoperative management only)

When care is split, the operating surgeon appends -54 for the intraoperative service; the physician assuming follow-up reports the same code with -55 (postoperative management only). Modifier -56 covers preoperative management. These split-care modifiers apportion the global package among providers.