Corporate Compliance

Tip: Using modifier -27

Compliance Monitor, August 31, 2005

Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!

Use modifier -27 for multiple outpatient hospital evaluation and management (E/M) encounters on the same date.

Use this modifier when a patient receives multiple E/M services performed by the same or different physicians in multiple outpatient hospital settings (e.g., emergency department, clinic, etc.)

  • Use this modifier if a patient was seen in two different hospital-based clinics on the same date of service
  • Only append modifier -27 to E/M service codes within the range of 92002-92014, 99201-99499, and with healthcare common procedure coding system codes G0101 and G0175
  • Append this modifier to the second subsequent E/M code when more than one E/M service is provided that same day in the same or different hospital outpatient setting
  • When reporting modifier -27, report with condition code G0 when multiple medical visits occur on the same day in the same revenue centers.

    The above tip is an excerpt from the book "Modifier Training Handbook for Hospital Billers and Coders," Copyright 2004 by HCPro, Inc. This book is an easy-to-use training guide for billers, coders, and their HIM supervisors and managers that's written in plain English and takes the confusion out of the appropriate use of hospital modifiers.



  • Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!

      Strategies for Health Care Compliance
    • Strategies for Health Care Compliance

      News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...

    • Compliance Monitor

      This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...

    • Medicare Weekly Update

      Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...

    • Medicare Update for Physician Services

      Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...

    Most Popular

    Related Articles