AAPC - Back to school
Results 1 to 3 of 3

Thread: Medicare 3-day global

  1. #1

    Default Medicare 3-day global

    AAPC: Back to School
    Does Medicare 3-day global period apply to different doctors in the same clinic? A Pt saw the nurse practitioner in the office, then was admitted the next day where one of our doctors made rounds. Do I need to delete the OV and just charge the rounds?

  2. #2
    Join Date
    Apr 2007
    Louisville, KY


    I'm not aware of the Medicare 3 day window impacting professional fee coding, only facility charges. According to everything I've read, the impact is only on the IPPS side. Pro fees are not part of IPPS normally.

    Last edited by kevbshields; 02-05-2012 at 08:33 AM.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  3. #3
    Join Date
    Apr 2007
    Columbia, MO


    Here is what I have on the revised 3 day rule as it will impact some physicians starting July 1:
    New modifier-PD -Diagnostic or related non-diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days—changes to Medicare 72 hour rule go in to effect July 1st, 2012.
    CMS is expanding the “three-day payment window” for outpatient services provided within 72 hours of an inpatient admission. As of July 1, 2012 the payment window will apply to both diagnostic and non-diagnostic services.
    Medicare will pay a reduced fee for physicians’ services that are clinically related to an inpatient admission, occur within 72 hours of the admission, and are furnished by a physician practice wholly owned or wholly operated by a hospital. The rule applies whether the inpatient and outpatient diagnoses codes are the same or different.
    Claims provided by any physician practice owned or controlled by a hospital will have to be held for at least three days prior to submission: The practice does not want to submit a claim without modifier PD, and then discover that the patient was admitted within 72 hours. The hospital is responsible to notify the practice of related inpatient admissions.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Medicare 90 day global calendar
    By rjenn86 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 02-12-2014, 04:34 PM
  2. 10 Day Global
    By braheny in forum E/M
    Replies: 2
    Last Post: 12-15-2011, 01:31 PM
  3. 90 day Global Period
    By mdemecs in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-31-2011, 05:16 AM
  4. 90 day Global Period
    By mdemecs in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-31-2011, 05:16 AM
  5. What to do after the 10 day global is over??
    By aarnold13 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 01-25-2010, 01:11 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.