help POS

[perkins05]

POS 11 or 22 or both?????

If an office has two Tax ID #'s can they billed both POS 11 and POS 22.
The POS 11 sees the patients and bill E/M?
The POS 22 bill chemo/infusions/injections doen by RN's?

Thanks

 

[ajs]

POS 11 or 22 or both?????

If an office has two Tax ID #'s can they billed both POS 11 and POS 22.
The POS 11 sees the patients and bill E/M?
The POS 22 bill chemo/infusions/injections doen by RN's?

Thanks

This is the CMS definition of POS 22, if you meet this description then you can use it:

"POS 22 Outpatient Hospital
A portion of a hospital which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization"

 

[perkins05]

Thanks AJS...If seen on same day do I attach modifier 25 to e/m?

 

[ajs]

Thanks AJS...If seen on same day do I attach modifier 25 to e/m?

(Under OPPS, modifier may be used only with E/M visit codes (with status indicator V) within the following code ranges: 92002-92014, 99201-99285, 99431, G0101, G0175, G0245, G0246, G0344 G0380-G0384 ~~Modifier used on an E/M code when it is reported with a procedure code that has a outpatient payment status indicator (OPSI) of "S" or "T." However, this does not preclude the provider from reporting this modifier with E/M codes that are assigned to an OPSI other than the "S" or "T" as long as the procedure meets the definition of "significant, separately identifiable E/M service" (Medicare Claims Processing Manual, chapter 4, section 20.6, Medicare transmittal 1045, September 1, 2006.)

That all depends on what exactly is being billed, where the services were rendered and who was providing the service.

 

[mitchellde]

i am confused, is this a physician with a clinic in the outpatient setting and an office setting? Or are you calling your office an outpatient clinic? Who are the nurses employed by ? If it is the facility nurse adminstering chemo then the physican cannot bill this. If it isyour office and not an outpatient clinic then ypu do not use POS 22