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ED Coding and Reimbursement Alert

Payment Policy Update:

New for July 1, 2012: Medicare Requires a PD Modifier During The Three Day Payment Window

Published on Mon Jun 18, 2012

Be aware of ED services provided within three days of admission to a hospital with your same owner Although the concept of non-payment for select services within 72 hours of admission to the same facility that houses your ED may be familiar, CMS has released additional guidance in how to report those services.Background: On Dec. 21, CMS rescinded Transmittal 2297, dated Sept. 2, 2011, and replaced it with Transmittal 2373. The new transmittal finalizes CMS payment modifier PD (Diagnostic or related non-diagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within 3 days), with a compliance date of July 1, 2012, says Ed Gaines, JD, CCP, Chief Compliance Officer for Medical Management Professionals in Greensboro, NC.On June 25, 2010, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (PACMBPRA) (Pub. L. [...]
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