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e&m outpatient clinic and e&m ER Visit

  1. Default e&m outpatient clinic and e&m ER Visit
    Medical Coding Books
    I am trying to bill for outpatient hospital charges. Pt had a clinic visit 99213 for chemo, and then went to the emergency room (99283), had blood work and testing. I know that I usually append modifier -25 to the E/M code, and the claim usually pays, but I have never had 2 e&m codes on one claim. I can use modifier -27 for multiple outpatient E/M encounters on the same date, but do i have to append modifier -25 to both E&M codes?

    Codes billed: 96374, 96375, 99283, 99213, j0692, j3370, 93000, and bloodwork 8XXXX

    should it look like this:
    99213 -25, -27
    99283 -25, -27

    someone help me please

  2. #2
    Columbia, MO
    when you are billing facility and have multiple E&M in either the same or different revenue centers and one visit has a procedure with a status S or T indicator, then all E&Ms for the claim must have a 25 modifier, the 27 modifier is for the second and subsequent E&M for the day so the first E&M will have a 25 only the second and subsequent will have a 25 and a 27. If you have more than 1 E&M in the SAME revenue center on the same day then the claim also needs a G0 condition code.

    Debra A. Mitchell, MSPH, CPC-H

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