Wiki ASC-Place of service 22, 24 or 11 Please Help!

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kwoodward

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I have a doctor who purchased all the equipment to do Colonoscopies in his office. He has been approved and performing them for a year or so. I am trying to understand is this considered an ASC?
Currently his AR is a mess. I am trying to clean it up. His EGD's and colonoscopies have been coded many different ways. They have had POS 22 or 24 for the "Endoscopy Suite" and 11 for the actual charges for the physician.
I am thinking the Endo Suite (different tax id than the provider) should be billed with a POS 24 and the codes have a TC modifier, and the physician's fees should be billed with a POS 24 and modifier 26. OR should they be POS office (11) with the modifiers described above?

ANY INSIGHT ON THIS WOULD BE GREATLY APPRECIATED!

kris
 
POS 24 vs 11

hi kris; POS IS THE KEY TO YOUR ANSWER! If pos is physicians office, you will use (POS) 11. If pos is an ambulatory facility use (POS)24.
I hope this answeres part of your question

cathleen dba ASC coder
 
kwoodward said:
I have a doctor who purchased all the equipment to do Colonoscopies in his office. He has been approved and performing them for a year or so. I am trying to understand is this considered an ASC?
Currently his AR is a mess. I am trying to clean it up. His EGD's and colonoscopies have been coded many different ways. They have had POS 22 or 24 for the "Endoscopy Suite" and 11 for the actual charges for the physician.
I am thinking the Endo Suite (different tax id than the provider) should be billed with a POS 24 and the codes have a TC modifier, and the physician's fees should be billed with a POS 24 and modifier 26. OR should they be POS office (11) with the modifiers described above?

ANY INSIGHT ON THIS WOULD BE GREATLY APPRECIATED!

kris
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Is the surgical suite accredited? Or does he just have two tax IDs? That is an important distinction.
Also- a POSr 24 is used for a free standing ASC. That means one that is not owned by a hospital or billing under hospital contracts.
A POS 22 ASC is one that is affiliated with a hospital and is billed under hospital payer contracts
If the doctor has a treatment room set up in his office and it is listed as such, the revenue code 761 is usually used for treatment rooms but you will need to check your payer contracts to determine how they want it to be billed.
 
I have a similar problem. My provider has a JACHO certified Treatment Room within his office suite. I believe I should bill the POS as 24 and Revenue Code 761 for the treatment room charges. Where can I find in writing that it is appropriate to billing revenue code 761 for a non-hospital location?
 
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