Wiki Help !!!!!!!! OHIO Medicaid denied POS 02 for TELEHEALTH SERVICES

[NishaJ]

Hi .....

If anyone came across this type of denial, OHIO MEDICAID denied POS 02 for Tele health service as invalid POS. I have checked in Ohio medicaid website, I could not find any information about using POS 02 for Telehealth service...

https://www.medicaid.gov/medicaid/benefits/telemed/index.html

http://medicaid.ohio.gov/Portals/0/...gInstructions/TelemedicineBillingGuidance.pdf

http://codes.ohio.gov/oac/5160-1-18v1

https://www.caresource.com/documents/py-0084-telemedicine-services-payment-policy/

In all these website, they are not at all speak about POS 02. So I think we can be billed with exact Place of service, where the Distant site provider is.

I need an advice on this.. Thanks in advance....

 

[CodingKing]

Medicaid is usually the last to accept any changes made. I'd continue to bill as prior to the new place of service code being created.

 

[mcpalmeter]

Pos 02

What really cheeses me is that these POS codes are part of standard code sets used by all payors subject to HIPAA legislation. Medicaid is indeed subject to HIPAA legislation. I would appeal and advise them accordingly so you do not have to keep appealing.

Just My Humble Opinion,

 

[NishaJ]

Thank you guys...
so we would continue to code the POS , where the physician exist instead of POS 02.....

 

[thomas7331]

The guidance from Ohio Medicaid on billing telehealth services, which you linked above ( http://medicaid.ohio.gov/Portals/0/...gInstructions/TelemedicineBillingGuidance.pdf )
states to bill with distant site provider's services with the place of service as the 'physical location of practitioner', so that's what I would recommend doing.