In simple words: If you visit different doctors or different outpatient departments within the same hospital on the same day, this code indicates that you had multiple encounters.

This modifier is used to indicate multiple outpatient hospital evaluation and management (E/M) encounters for the same patient on the same date of service, with different providers or in different hospital outpatient settings. It applies exclusively to hospital outpatient departments (e.g., hospital emergency department, clinic, critical care).

Example 1: A patient presents to the emergency department (ED) with abdominal pain and is seen by an ED physician (9928X). Later that day, the patient is admitted to the hospital and is seen by a hospitalist for an initial evaluation (9922X). Modifier 27 would be appended to the hospitalist's E/M code., A patient has a scheduled appointment with their primary care physician in a hospital-based clinic (9921X). While at the hospital, the patient experiences dizziness and is seen by a cardiologist in the same hospital's cardiology clinic (9924X). Modifier 27 would be appended to the cardiologist's E/M code., A patient receives wound care in the outpatient wound care center (9920X) and later the same day goes to the ED in the same hospital for a different complaint and is seen for an unrelated issue (9928X). Modifier 27 would be appended to the ED E/M code.

Documentation should clearly support the medical necessity of each separate E/M service and demonstrate that the encounters were distinct and involved different providers or different hospital outpatient settings.

** Check with individual payers for their specific reimbursement guidelines for E/M services with modifier 27.