Wiki Mod- PD

[Linda77]

The clinic I work in has been purchased by a hospital and now the Mod PD will need to be implemented. I understand it is added to radiology services, therapeutic injections and some other procedures in the office. We are getting pressure from the higher up that claim we must add it to the E/M services too. I thought that this Mod is not to be put on E/M services. I would really appreciate any info/links that I can share with management. Or if I am wrong please explain why. Thanks!

 

[sarahjanejones]

I do believe you need to put the 'PD' on the E/M code as this will cause the E/M to be paid at the facility rate rather than 'office' rate.

 

[sarahjanejones]

In MLN Matters, number SE1232, on page 9, there is a question that address this exact scenario.

"The wholly owned or wholly operated physician practice would bill the related outpatient E/M visit with modifier PD and the Medicare claims processing contractor would pay the physician practice at the facility rate."

I hope this is helpful!

Have a great evening!

 

[Linda77]

Thank You