Certified Inpatient Coding (CIC) Practice Exam

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What is the definition of a "modifier" in coding?

A code that signifies a service has been denied

A prefix that is added to a physician's code

A two-digit code that provides additional information

A modifier in coding is indeed defined as a two-digit code that provides additional information about a procedure or service performed by a healthcare provider. These modifiers are essential as they clarify the circumstances surrounding a service, allowing for more accurate billing and reporting. For example, modifiers can indicate that a service was performed on a specific body part, that it was bilateral, or that it was an unusual service that required additional resources.

Modifiers enhance the specificity of coding by providing details that can affect reimbursement and claims processing. By using modifiers correctly, coders ensure that the nuances of patient care are fully captured and communicated to payers, which can prevent claim denials and inaccuracies.

The other options describe different coding concepts that do not align with the definition of a modifier. For instance, a code indicating a service denial does not augment a procedure but rather states that the service was not approved for coverage. A prefix added to a physician's code isn't a commonly accepted term in coding practices, and a code that cancels a procedure describes a completely separate action in the coding process. Thus, the most accurate definition is that a modifier is a two-digit code providing additional information.

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A code that cancels a previously assigned procedure

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