CMS Establishes New 3-Day Payment Window Modifier

CMS has established a new payment modifier — PD Diagnostic or related nondiagnostic item or service provided in a wholly owned or operated entity to a patient admitted as an inpatient within 3 days, according to an AAPC report.

Physicians, suppliers and providers must append modifier PD to preadmission diagnostic and admission-related nondiagnostic services reported with HCPCS Level II or CPT codes subject to the 3-day payment window policy.

Modifier PD is available for claims with dates of service on or after Jan. 1, 2012. CMS advises entities to begin coordinating their billing practices and claims processing procedures with hospitals to ensure compliance with the 3-day payment window policy no later than for claims received on or after July 1, 2012.

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