• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki kristenandcadencenana@gmail.com

Create Wiki
C

cpsd633a

Guest
Messages
2
Best answers
0
I need some help on the correct use of modifier 25 and 27 on two ER visits on the same day on a Medicare patient. Since this is a Medicare patient, the two visits must be combined on the billing side, since they were on the same date of service. Do I need to add the modifier 25 to each E/M level plus the modifier 27 to the second visit? Or do I need to add modifier 25 just to the first E/M level and only the modifier 27 to the second visit? I can't seem to find clarity in the CPT Assistant or any where else. Any help would be appreciated. Thanks!
 
I assume you are coding for the facility as the physician does not use the 27 modifier. you only need a 25 modifier if a significant procedure was performed at either encounter. If so then you use the 25 on all facility E&Ms for that day regardless of revenue center. So if a procedure were performed at say the second encounter then you code 2 E&M s both with a 25 modifier and the second E&M also gets a 27 modifier and you need a G0condition code on the claim.
 
thank you!

Thank you for the reply. That is the way that we are coding them but I just wasn't sure if that was correct or not. I do code for an acute care hospital, sorry I forgot to put that in my post. It seems redundant to put the modifier 25 on both E/M levels, so that is why I as was second guessing myself. Again thank you so much for your quick reply. Have a great day:)
 
You must log in or register to reply here.
Top