jerseygirl66
Networker
Hi all,
I'm hoping someone can point to a source of reference. When is place of service 57 (Non-residential Substance Abuse Treatment Facility) versus place of service 11 (office) for substance abuse?
My new client has some claims that were posted to place of service 11, CPT H2036 and were processed with a copay. Same patient, same CPT, claim was posted with place of service 57 and the claims went to deductible. Insurance has said it was processed to deductible due to place of service (facility). I understand that some plans have higher deductibles when a facility setting is used versus an office setting.
Would it be inappropriate to bill claims under place of service 11? This is a freestanding office, not related to a hospital in any way.
Thanks in advance for any insight.
I'm hoping someone can point to a source of reference. When is place of service 57 (Non-residential Substance Abuse Treatment Facility) versus place of service 11 (office) for substance abuse?
My new client has some claims that were posted to place of service 11, CPT H2036 and were processed with a copay. Same patient, same CPT, claim was posted with place of service 57 and the claims went to deductible. Insurance has said it was processed to deductible due to place of service (facility). I understand that some plans have higher deductibles when a facility setting is used versus an office setting.
Would it be inappropriate to bill claims under place of service 11? This is a freestanding office, not related to a hospital in any way.
Thanks in advance for any insight.