Wiki Billing 99214 with POS 24

[Blackhorse]

Is 99214 with POS 24 allowed? I have always thought that E/M code can only be billed with POS 11, but we have got paid by one of the Medicare Advantage plan all the time. Am I wrong?

 

[thomas7331]

It is acceptable from a coding standpoint, assuming the documentation supports it, but it may or may not be allowed depending on the specific payer's reimbursement policies.

I believe that Medicare would cover the physician fee in this situation, but I don't think that an ASC is allowed to bill an E/M service as a facility fee. So unless there is another service that the ASC is billing for at that encounter, they are likely not going to be compensated for allowing the physician to use their space.

 

[Blackhorse]

It is acceptable from a coding standpoint, assuming the documentation supports it, but it may or may not be allowed depending on the specific payer's reimbursement policies.

I believe that Medicare would cover the physician fee in this situation, but I don't think that an ASC is allowed to bill an E/M service as a facility fee. So unless there is another service that the ASC is billing for at that encounter, they are likely not going to be compensated for allowing the physician to use their space.

We own the facility. We bill 99214 & 64483 with POS 24 on HCFA, and bill 64483 with POS 24 with UB04.