Wiki New PO modifier

[HMJ]

I've read somewhere(I can't find it now though)that the PO modifier is to only be applied to facility claims...not professional claims. Does anyone know if this is true??


Effective January 1, 2015, the definition of modifier ?PO? is ?Services, procedures, and/or
surgeries furnished at off-campus provider-based outpatient departments.? This
modifier is to be reported with every HCPCS code for all outpatient hospital items and
services furnished in an off-campus provider-based department of a hospital.

This modifier should not be reported for remote locations of a hospital (defined at 42 CFR
413.65(a)(2)), satellite facilities of a hospital (defined at 42 CFR 412.22(h); see
http://www.ecfr.gov/cgi-bin/textidx?SID=867b6f12ebf5c84c0469ca86a7bbe88a&mc=true&node=pt42.2.412
&rgn=div5#se42.2.412_122), or for services furnished in an emergency department.

 

[jimuthr]

Yes, only the facility appends the "-PO" modifier. This can be found in Pub 100-04, transmittal 3280.

 

[jfogelquist]

Yes, only the facility appends the "-PO" modifier. This can be found in Pub 100-04, transmittal 3280.

Does this include Urgent Care Centers owned by the hospital?

 

[thomas7331]

Urgent Care clinics that are off campus are included, but your hospital should give you guidance as to which of their locations qualify as off campus provider based outpatient departments. This should not be a decision made by individual coders, in my opinion. Our hospital is hard-coding the locations for the applicable areas so the modifier will be applied appropriately by the system based on the location of the services and the coders will not be responsible for deciding whether or not the modifier is required.