General

For the Week of May 23, 2016

In regard to assigning the mandatory modifier PO on hospital outpatient claims, can the same claim have both a HCPCS with the PO modifier and a HCPCS without the PO modifier? 

As you say, reporting of this two-digit modifier began mandatory beginning on January 1, 2016. It must be reported with every code for outpatient hospital items and services furnished in an off-campus provider-based department (PBD) of a hospital.

In answer to your question, yes, a single hospital outpatient claim (type of bill 13X) could have a HCPCS code with the PO modifier and without the PO modifier such as when a patient is treated at an off-campus provider-based department and the on-campus hospital on the same day.