tci ED Coding & Reimbursement Alert - 2012 Issue 7

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

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ED may be familiar, CMS has released additional guidance in how to report those services.Background: On Dec. 21, CMS rescinded Transmittal 2297, dated Sept. 2, 2011, and replaced it with Transmittal 2373.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...

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