Wiki Revenue codes

[britney.thode@yahoo.com]

Looking for guidance - new coder to CAH ED visits. Recently, my clearinghouse has been stopping Medicare claims with 2 different e/m levels with different revenue sites for "missing/invalid CPT modifier". Does anyone have experience with this? Is modifier 27 appropriate if they were only seen in the Emergency Department and NO other outpatient service?

 

[mcollins130]

Modifier 27 is used when they had another outpatient hospital e/m the same day. What revenue code are you using?

 

[britney.thode@yahoo.com]

Facility 99282-0450, P/F 99282 0981. Provider was an MD so I know the P/F isn't needing the GF

 

[mcollins130]

Facility 99282-0450, P/F 99282 0981. Provider was an MD so I know the P/F isn't needing the GF

It is correct. My encoder flags for the same reason, but our clearinghouse doesn't hold the claim. You will have to bypass the edit.