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General Surgery Coding Alert

Reader Question:

Learn Modifier PD Payment Impact

Published on Tue Dec 18, 2012

Question: Our surgery group practices in a freestanding facility not operated by a hospital. When a patient comes in to see one of our surgeons for an appointment and is admitted to a hospital within three days, do we need to use modifier PD? Illinois Subscriber Answer: If the entity you’re coding for is not wholly owned or operated by a hospital, then you don’t need to append modifier PD (Diagnostic or related nondiagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days). On the other hand, those entities (practices, etc.) that are wholly owned or operated by a hospital and that provide any diagnostic or related non-diagnostic services to a patient who is admitted to that hospital within three days must append modifier PD to the codes for those services. They must apply the modifier [...]
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