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.

Instructions

This is a payment modifier to use with diagnostic or related non-diagnostic items or services a provider delivers in a wholly owned or operated entity to a patient who becomes an inpatient within three days.

Correct Use

• For preadmission diagnostic and non-diagnostic services related to the admission
• Entity providing service is wholly owned or operated by the hospital admitting the patient within three days
• Medicare payment allowed for professional component of codes with a technical professional split when a provider delivers within three calendar days

Incorrect Use

• Entity is not wholly owned or operated by a hospital