modifier 27

NIKI01

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hello,

I was wondering if someone could let me know how to use modifier 27. I am using this modifier on the second visit on the Facility site when patients are coming to ED twice per day. I did research and I found out that this modifier need to be used on Facility level. However, according to edit by coding program that we use the modifier 27 should be used on Professional site. Per lead coder it should be use on Professional site also. I am confused now.

thank you so much for any help,
Niki
 

SharonCollachi

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Modifier 27
What you need to know
Append modifier 27 when reporting multiple outpatient hospital evaluation and management (E/M) services on the same date.

Modifier 27 was created exclusively for hospital outpatient departments (ex. hospital emergency department, clinic, and critical care).

Note: Physician practices may not use this modifier. This modifier should only be reported on the UB-04 Part A claim form or electronic equivalent.

Hospitals may append modifier 27 to the second and subsequent E/M code to indicate that the E/M service is a “separate and distinct E/M encounter” from the service previously provided that same day in the same or different hospital setting.
Hospitals may append modifier 27 to the range of E/M service codes listed below.
92002-92014 (Ophthalmological E/M services)
99281-99285 (Hospital type A emergency department visits)
99291-99292 (Critical care)
G0175 (Interdisciplinary team conference)
G0380-G0384 (Hospital type B emergency department visits)
G0402 (Initial preventive physical examination)
G0463 (Hospital outpatient clinic visit for assessment and management)
Report condition code G0 (zero) with modifier 27 when multiple medical visits occur on the same day in the same revenue centers.

From here: https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/downloads/MM8572.pdf
 

NIKI01

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Thank you so much,

My question is--should modifier -27 be used on Professional or on Facility site? I use this modifier on Facility site when I am charging the levels. However, the coding program suggesting to use on levels for the Professional site. I am confused!

Thank you again,
NIKI
 
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