Reader Question: Modifiers -27 and -60

Question: Are modifiers -27 and -60 approved for outpatient use? Does Medicare approve them?

Michigan Subscriber

Answer: According to CPT 2001, modifier -27 (multiple outpatient hospital E/M encounters on the same date) is approved for hospital outpatient use. It is not an approved Medicare modifier. To code for a situation that would fall under this modifier, use the -G0 condition code (multiple medical visits on the same day in the same revenue center but visits were distinct and constituted independent visits). See the February 2001 and December 2000 APC Alert for more information about using the -G0 condition code.

CPT 2001 says modifier -60 (altered surgical field) is not approved for outpatient use. HCFA also does not approve the modifier because of a concern that modifier -60 will be used routinely where additional work has already been included in the code.

Until further notice, HCFA has instructed surgeons to continue using modifier -22 (unusual procedural services). However, modifier -22 is not an outpatient-approved modifier. This means that, for now, you have to code procedures falling under APCs according to the procedure itself without considering the extenuating circumstances.

- Published on 2001-03-01