Modifier -27


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According to CPT, modifier -27 is used for "multiple outpatient hospital E/M encounters on the same date".
Now according to the E/M exam study guide, it states that modifer -27 should not be used to report multiple E/M servies that are performed on the same date byt the same physician - you should combine the elements of the exam and bill one service.
This makes me curious as to how to apply this in the ED? At the hospital, sometimes patients will come in more than once in a calendar day, unscheduled, with the same complaint and see different ED providers but are being treated for the same condition and may leave with the same diagnosis. In these instances would you just code out the 2 providers individually or would you combine them as they are in the same outpatient setting and same tax id#, etc.
Any ideas?