Radiology Question for the Week of March 21, 2016

Question:

I know that on January 1, hospitals that operate off-campus provider-based outpatient departments must include modifier PO with the billing code for each item and service furnished in those departments. I don’t know, however, whether it should be applied for radiology services. Can you answer this question? 

Answer:

The determining factor is whether or not the item or service is being paid through the hospital outpatient prospective payment system (OPPS) on and after January 1, 2016. 

If an item or service is being provided by an applicable provider and is being paid through the OPPS, then the PO modifier (services, procedures and/or surgeries performed at off-campus provider-based outpatient departments) should be applied. If a service is not paid through the OPPS, it should not have the PO modifier applied. 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.