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Modifier 27 - Multiple Outpatient Hospital E/M Encounters on the Same Date - For hospital outpatient reporting purposes, utilization of hospital resources related to separate and distinct E/M encounters performed in multiple hospital settings on the same date may be reported by appending the modifier 27 to each appropriate level outpatient and/or emergency E/M code (s). This modifier provides the means of reporting circumstances involving evaluation and management services provided by physician (s) in more than one (multiple) outpatient hospital setting (s) (eg, hospital emergency department, clinic). NOTE: This modifier is not to be used for physician reporting of multiple E/M services performed by the same physician on the same date.
On the following webpage, (excerpt provided) AAPC allows for two E/M services for return visits to the ED with the same chief complaint. How can this be considered separate and distinct?
On the following webpage, (excerpt provided) AAPC allows for two E/M services for return visits to the ED with the same chief complaint. How can this be considered separate and distinct?
Unique to the outpatient facility side is modifier 27 Multiple outpatient hospital E/M encounters on the same date. In addition, condition “GO” is assigned on the UB-04 claim form when multiple visits from within the same revenue center on the same date are performed. Facilities may be reimbursed when more than one E/M is performed on the same calendar date.
For example, a patient arrives in the ED at 10:07 a.m. for complaints of severe headache. Treatment is provided and the patient is discharged. At 7:00 p.m., the patient returns with worsening complaints of severe headache accompanied by nausea, vomiting, and severe photophobia. The patient is treated again and discharged.
On the physician side, it’s inappropriate to code and bill for two ED visits for the same physician/physician group; on the facility side, however, coding would be:
99282 Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity… *(or the appropriate ED level) for visit at 10:07 a.m.
99282-27 *(or the appropriate ED level) for visit at 7:00 p.m.
99282 Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity… *(or the appropriate ED level) for visit at 10:07 a.m.
99282-27 *(or the appropriate ED level) for visit at 7:00 p.m.
