General Question for the Week of January 14, 2019

Question:

Can the same hospital outpatient claim have both a HCPCS with the PO modifier and a HCPCS without the PO modifier?

Answer:

Yes, a single hospital outpatient claim (Type of Bill 13X) could have HCPCS with the PO modifier and HCPCS without the PO modifier (e.g., a patient is treated at an off-campus PBD and the on-campus hospital on the same day), according to the FAQ document posted by the Centers for Medicare & Medicaid Services at  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/PO-Modifier-FAQ-1-19-2016.pdf.

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