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Thread: PA e/m visit and modifier 81

  1. #1
    Join Date
    Apr 2007

    Default PA e/m visit and modifier 81

    AAPC: Back to School
    I would like to see if anyone out there is running into the same problem we are having with Liberty Northwest WC. They are denying our claims for e/m encounters stating they require a state mandated modifier. When we called them they told us we need to attach modifier 81 on any E/M office visit that is performed by a PA. Does not matter if the patient is a new or establish patient. Has anyone else heard of this? Can anyone suggest a resource I can use to appeal this. I am wondering if they are just delaying payment on these claims.


    Last edited by coderforlife; 10-26-2010 at 11:15 PM.

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    81 is a procedure code modifier for minimal assistant surgeon and is not to be used on E&M codes. They are probably wanting someting like the SA modifier.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3

    Default Mod 81

    This is an Oregon workers compensation rule

  4. #4


    Per OR Workers Comp Prior to April 1st , 2015 they wanted modifier 81 on all PA claims , including E/M's , xrays etc. April 1st 2015 this is no longer mandated ! Yes

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