AHA Coding Clinic® for HCPCS - 2001 Issue 3

Hospital outpatient services and Modifiers -25 and -27

Modifier -27 According to Program Memorandum (PM) Transmittal A-01-80 CMS will recognize and accept the use of modifier -27 on hospital Outpatient Prospective Payment Service (OPPS) claims effective for services on or after October 1, 2001. Modifier -27 was originally created to identify a hospital facility reporting a situation of a patient receiving multiple evaluation and management services performed by the same or different physician(s) in multiple outpatient hospital settings on the same day. However, it wasn’t approved for usage by CMS until recently. The general guidelines for Modifier -27 are as follows: A. Modifier -27 should be...

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