1. M

    Question Remote Physician (working from home) POS Code Clarification

    If a therapist (lcsw, lmf, masters level) works from THEIR home seeing patients through telehealth services, what place of service code do you use? The therapist doesn’t’t work from “office” but they work at HOME REGULARLY can I still use POS 11 or something else?
  2. T

    Question 99406 denial

    I am getting a denial from Medicaid as secondary to Medicare. Primary Cpt Code 99309 (NURSING FAC SUBSE DETAILED) was paid by Medicaid. Medicaid is denying Second cpt code 99406 for POS. POS is 31 for this provider for both codes. Is this POS for this code not payable per Medicaid guidelines for...
  3. C

    POS Question - Senior Center

    Looking for any input please. I have a provider who wants to bill patient visits (minor illness, cough / cold etc.) performed at a Senior Center as POS 11. I don't think this can be done, nor do I know of any pertinent POS. The provider is trying to say it is an "extension of his office" and...
  4. M

    Place of Service questions

    Hello! I am a somewhat new biller and got my experience solely from the office I currently work at and through AAPC billing course. I work for an Outpatient Drug and Alcohol treatment center, we also provide co-curring mental health/substance use services. The POS, Place of Service is always a...
  5. O

    Question Place of Service for Surgery Consults at the Hospital

    Hello. I recently started working for a surgeon. This is my first time coding for a physician that sees patients in a hospital setting. He is on call and sees patients in the ED, ICU, etc..I am often unclear on which place of service to choose for his E/Ms. He mostly does surgery consults...
  6. P

    CPT 59866 POS

    Can cpt 59866( Multifetal Pregnancy Reduction(s) be billed with POS 11? I have a claim from BCBS denying stating POS is invalid.
  7. C

    using POS 3 (school setting) for outpatient OT

    I'm looking to find out if anyone has experience billing occupational therapy services with POS 3 (school setting). I bill for a pediatric occupational therapist who wants to start seeing patients in the school setting (she currently bills POS code 11 for the office setting). I'm reviewing her...
  8. D

    Obtaining Correct POS From Facility SNF/Assisted

    My Dr does rounds at a local what I thought was a SNF, I billed 99305 with POS 31 the address of the facility and the referring physician but still recieved denials from Medicare. Do I continue to try and get ahold of someone to ask at the facility or do I call and ask Medicare?
  9. A

    Independent Laboratory Billing Place of service code

    Hello! We are an independent lab running lcms(80307) and definitive(G0480-G0483) billing for urine collected at the facility the patient is receiving care from and sent to us. United Healthcare (UHC) just started denying our claims for box 24B and box 32. We have always billed with POS 81 in box...
  10. C

    Home visit for Hospice Patient

    I have a provider that will be doing a home visit to a hospice patient for a non hospice problem. How do we bill for this? Modifiers? Thank you!
  11. D

    My physician asked to consult in ER

    I'm a chart auditor for a large urology group and there is some dispute on our providers providing a consult in the ER. Patient is Medicare and we are NOT admitting the patient to our service. I was told that we should be using 99201-99205 or 99212-99215 as the patient is "out patient" and we...
  12. B

    CPT code denying because of the place of service

    Hello, Just wondering if anyone has had this problem before. We are in CA and we have sent some claims to HMOs and they are denying the cpt 11055 with POS 33 but they are denying it because of that. We have tried 32 as well and same response. This particular insurance company always plays...
  13. C

    Temporary POS Due to Flooding

    Help! A physical therapy office I help with experienced massive flooding due to the storms in SoCal. They will be unable to use their office for at lest 3-4 weeks. In the interim, they want to take their patients, who are mostly post-op surgical, to an ASC (where many of the patient's were...
  14. P

    CPT codes 99201-99204 with POS 65 for AKI pts seen in the Dialysis Unit

    Per the RPA, we are to use 90935 and 90945 with POS 65 for our AKI patients who will be seen in the dialysis units instead of the hospital outpatient unit as of 1/1/17. My questions is this, can we also use 99201-99204 for those AKI patients who are new to our practice who we see for the first...
  15. L

    Sleep Study POS

    My pulmonologist is now reading sleep studies done at an independent sleep study lab. I think the place of service is going to be 49 for our billing of the professional component. Can anyone confirm? Thanks, Lorrie
  16. A

    Home health POS question

    Hello Does anyone have an CMS information that states physicians cannot bill E/M codes 99211-99215 with POS 12 (home). I have seen some doctors bill with this POS and E/M codes and I am not sure if CMS will allow the location to bill with office/outpatient. thanks
  17. L

    -TC Portion Pathology in ASC

    I'm new to both pathology and ASC billing. I have billed our -TC portion of the pathology that was done in our ASC. I billed 88305-TC with a POS of 24. I am being denied with Cigna for inconsistent modifier use and an Aetna denial because "treatment has been rendered by the payer to be...
  18. E

    Consult with POS ER for Medicare

    I have been coding ER visit codes 99281-5 for the crosswalk for Medicare Consults when the POS is the ER and not crosswalking to OP visit codes new or established for Hospitalist and Orthopaedic consults ;I use those when the POS is Obsrv. Can anyone tell me if I am correct to bill the ER codes...
  19. R

    POS 19, new for 2016

    Does anyone have insight on when to use place of service 19? The CMS description states "A portion of an off-campus hospital provider based department...". We are private physician practice and are trying to clarify if POS 19 is for hospital employed physicians only. Any input is greatly...