"CPT Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.""

2012 New modifiers

Medicare HCPCS modifier PD will be available to wholly owned or wholly operated entities beginning January 1, 2012 and may be appended to
Part B claims lines to identify preadmission services that are subject to the 3-day window policy.

Full Description: Modifier PD - Diagnostic or related nondiagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within 3 days, or 1 day.

Appending modifier PD will alert claims processing systems to provide payment only for the PC for CPT/HCPCS codes with a TC/PC split and to pay services without a PC/TC split at the facility rate when they are provided in the 3-day (or, in the case of non-IPPS hospitals, 1-day) payment window. The facility rate will be paid for codes without a TC/PC split to avoid duplicate payment for the technical resources required to provide the services.

Modifier SC - Medically necessary service or supply 

See also "List of all Modifiers"

2013 Modifier Updates
Blogger Widget

Popular Posts