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Mod 25 & 27

  1. Default Mod 25 & 27
    Exam Training Packages
    Hi to all,

    Good Day to everyone, I have a problem on how to use Modifiers 25 & 27 together on an E/M sevice (Out Patient), can I use it together? the scenario was this, a patient made a follow-up on his Primary care provider and medication was administered for pain relief. He was then referred to another physician on the same medical group, patient went to see PHY2 on the same day, should I use Modifier 25 & 27 to the E/M service of the PHY2, because he (PHY2) also administered a medication to the patient (Mod 25), and he (PHY2) also saw this patient on the same date (Mod 27). Need help everyone, I do appreciate your help on this..


  2. #2
    Columbia, MO
    Assuming you are coding for the facility the yes.
    Both E&Ms will need the 25 modifier even if only provided a procedure and the second E&M will need a 27 modifier and G0 condition code will be required to be on the claim, if both occured in the same revenue center, although your software may auto append the condition code.

    Debra A. Mitchell, MSPH, CPC-H

  3. Smile Mod 25 & 27
    Hi mitchellde,

    Thanks for your help, i will suggest that and see how the insurance will treat this unusual case, thanks again, i really appreciate your help

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