Modifier 27 in facility coding
Modifier 27 is for hospital/outpatient facilities to use when multiple outpatient hospital Evaluation and Management (E/M) encounters occur for the same member on the same date of service. Modifier 27 is exclusive to hospital outpatient departments, including hospital emergency departments, clinics and critical care.
Append modifier 27 to a separate, subsequent and distinct E/M service if the patient receives more than one E/M service in the same hospital, on the same day, with different providers.
- AI modifier
- Anatomic modifiers
- Anesthesia modifiers
- AT: Active treatment
- FT: Unrelated critical care services
- GA, GY and GZ: Medicare non-coverage notification
- GN, GO & GP: Therapy type
- JW and JZ: Drug waste
- UD and UA: Treated and released or admitted/transferred (Medicaid only)
- 59, XE, XS, XP, XU: Distinct services
- 22: Unusual procedural services
- 25: Significant service separate from E&M service
- 26 and TC: Professional and technical components
- 27: Multiple E/M services in hospital outpatient departments
- 33: Preventive service
- 50 & 51: Bilateral and multiple procedures
- 52: Reduced services
- 53: Discontinued procedure
- 54 & 55: Surgical care and post-op care
- 56: Pre-operative management only
- 57: E&M service same day or before major surgery
- 62: Two surgeons
- 73 & 74: Discontinued outpatient surgery
- 76 & 77: Repeated procedures, same day
- 78: Unplanned return to operating room
- 80, 81, 82: Assistant at surgery