So you've looked at your readmission data, and you've found a problem. One nursing home or SNF is sending back a large number of patients for readmission within 30 days.
In December 2011, Detroit Medical Center (DMC) got word that it had been selected as one of only 32 medical organizations in the country to participate in Medicare's new Pioneer Accountable Care Organization (ACO).
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 three days or one day) is now included in the I/OCE, according to January updates detailed in Transmittal 2370.
Q Addendum B of the APC updates for 2012 indicates the new molecular pathology codes have status indicator E (noncovered service, not paid under OPPS). Our laboratory director said we should report these new codes in addition to the codes that are payable. Can you explain why?
As technology evolves, providers can perform more procedures at the patient's bedside than they ever could in the past. Previously, they could only perform these procedures in another department of the hospital, and they had to charge separately for them.
