Wiki Billing Office visit while pt is inpatient mental health

[sharon.strong@lpnt.net]

When a patient is seen for an unrelated medical problem in the physician office during a mental health admission, what is the proper way to bill? Medicare is denying, based on patient's inpatient status. Did we need a modifier?

 

[mitchellde]

You need to use the POS of the inpatient mental health facility.

 

[sharon.strong@lpnt.net]

Even though the service was performed in outpatient setting? We would need to use their POS? Do you know where I can find some resource that I can show our billers, in case this comes up again? Thank you so much for replying. I appreciate your help.

 

[mitchellde]

This was a new transmittal issued in 2012 effective April 1 2013. Look up MM 7631.

 

[sharon.strong@lpnt.net]

Thank you! I also found back up in the Medicare Claims Processing Manual, CH 26 Sections 10.5 and 10.6. I feel better now! Thanks again.