AAPC - Back to school
Results 1 to 2 of 2

Thread: e&m outpatient clinic and e&m ER Visit

  1. #1

    Default e&m outpatient clinic and e&m ER Visit

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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

Similar Threads

  1. ER to Outpatient Clinic visit coding question
    By cdlemings in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 10-14-2014, 06:00 PM
  2. 2 E&M Visits In 1 Day And An OutPatient Visit
    By julieclifton2011 in forum OB/GYN
    Replies: 1
    Last Post: 07-07-2011, 09:43 AM
  3. Washington L&I visit with L&I personel only
    By cnramsey in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-09-2009, 11:07 AM
  4. Home Visit & ER & Admission??
    By southbaymed in forum E/M
    Replies: 3
    Last Post: 05-26-2009, 09:11 AM
  5. Home Visit & ER & Admission??
    By southbaymed in forum Emergency Department
    Replies: 0
    Last Post: 05-15-2009, 01:02 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.