# PA e/m visit and modifier 81



## coderforlife (Oct 26, 2010)

I would like to see if anyone out there is running into the same problem we are having with Liberty Northwest WC. They are denying our claims for e/m encounters stating they require a state mandated modifier. When we called them they told us we need to attach modifier 81 on any E/M office visit that is performed by a PA. Does not matter if the patient is a new or establish patient. Has anyone else heard of this?  Can anyone suggest a resource I can use to appeal this. I am wondering if they are just delaying payment on these claims.

Thanks

Coderforlife


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## mitchellde (Oct 27, 2010)

81 is a procedure code modifier for minimal assistant surgeon and is not to be used on E&M codes.  They are probably wanting someting like the SA modifier.


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## mlian (Jul 13, 2011)

*Mod 81*

This is an Oregon workers compensation rule


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## Thath041 (Jul 28, 2015)

Per OR Workers Comp Prior to April 1st , 2015 they wanted modifier 81 on all PA claims , including E/M's , xrays etc. April 1st 2015 this is no longer mandated ! Yes


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