modifier 27


Best answers
Hello everyone, can someone tell me when it would be appropriate to attach mod 27? I do both facility and pro-fee for Emergency Medicine, I know that it isn't for pro-fee side, but when would I use it for facility?
I'm sorry but I am kind of confused with the wording for this modifier in the cpt book. Because it says Hospital resources related to separate and distinct E/M encounters performed in multiple outpatient hospital settings on the same date may be reported by adding modifier 27, so does that mean for different places: example seen in ER then seen in clinic or can it be for when seen x2 or more for the same date in the ER?..thank you alice


True Blue
Columbia, MO
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It means mutliple oupatient encounters regardless of revenue center. If the patient has 2 ER encounter on the same day the second one needs a 27 modifier. If the patient is seen in the ER (450 rev center) and in the Clinic (510 rev center) on the same day then the second one needs a 27 modifier, If one visit contains a significant procedure then all E&Ms for the day must have a 25 modifier as well. so you could have:
revenue center 510 99213-25 20610-RT
revenue center 450 99282-25,27
revenue center 510 99213-25
revenue center 450 99282 -25,27 96372
revenue center 450 99283 - 25
revenue center 450 99284 - 25,27 96372
this encounter must also have a G0 condition code for two visits in the same revenue center with a significant procedure.
In the facility you must look at all encounters for the day regardless of revenue center.