Cardiology Coding Alert

Reader Question:

Base POS on Face-to-Face Setting, Usually

Question: If I’m coding for the PC of a test performed in an outpatient hospital, do I use the POS of where the cardiologist interpreted the test (office) or the outpatient hospital?

Connecticut Subscriber

Answer: Because the face-to-face part of the service happened at the outpatient hospital, that’s the POS you should report. Choose between POS 19 (Off campus-outpatient hospital) and POS 22 (On campus-outpatient hospital) for the outpatient hospital POS.

Support: In Medicare Claims Processing Manual, Chapter 12, Section 150, you’ll find a statement that “As a general policy, the POS code assigned by the physician/practitioner for the PC of a diagnostic service shall be the setting in which the beneficiary received the TC service.”

Medicare provides exceptions to the general policy. If the beneficiary is a hospital inpatient or outpatient, always report the inpatient or outpatient POS, regardless of the actual setting of the technical and professional components.

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