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I need some help on the correct use of modifier 25 and 27 on two ER visits on the same day on a Medicare patient. Since this is a Medicare patient, the two visits must be combined on the billing side, since they were on the same date of service. Do I need to add the modifier 25 to each E/M level plus the modifier 27 to the second visit? Or do I need to add modifier 25 just to the first E/M level and only the modifier 27 to the second visit? I can't seem to find clarity in the CPT Assistant or any where else. Any help would be appreciated. Thanks!
 
I assume you are coding for the facility as the physician does not use the 27 modifier. you only need a 25 modifier if a significant procedure was performed at either encounter. If so then you use the 25 on all facility E&Ms for that day regardless of revenue center. So if a procedure were performed at say the second encounter then you code 2 E&M s both with a 25 modifier and the second E&M also gets a 27 modifier and you need a G0condition code on the claim.
 
thank you!

Thank you for the reply. That is the way that we are coding them but I just wasn't sure if that was correct or not. I do code for an acute care hospital, sorry I forgot to put that in my post. It seems redundant to put the modifier 25 on both E/M levels, so that is why I as was second guessing myself. Again thank you so much for your quick reply. Have a great day:)
 
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