Corporate Compliance

Tip: Using modifier -27

Compliance Monitor, August 31, 2005

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.

  • Most Popular