Health Information Management

Modifier -27 back in service

APCs Insider, April 1, 2005

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Modifier -27 back in service

QUESTION: My understanding is that modifier -27 is deleted for 2005 OPPS.  Is that true?

ANSWER: For about three months, modifier -27 was out of service. In the January 2005 Outpatient Code Editor (OCE), modifier -27 (Multiple outpatient hospital E/M encounters on the same date) was deleted from the table of approved modifiers. See CMS Transmittal 385/100-04.

However, further instructions related to the status of modifier -27 were included in the April 2005 quarterly update of the OPPS. CMS Transmittal 514/100-04, dated March 30, 2005, reinstates the use of modifier -27. This change is effective retroactive to January 1, 2005.

Go to the following Web site (www.cms.hhs.gov/manuals/pm_trans/R514CP.pdf) to read the instructions in their entirety. The announcement appears on p. 11 of the Transmittal.



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