Wiki Place of service

[heartyoga]

We read echocardiograms for echoes performed by another facility through a cloud based CPAC system. We bill for the reading part 93306-26 and they will for the technical component.

We read them in the clinic. Therefore, we think we should be it as place of service 11 office.

The downside to this is the insurances particularly Medicare think we are performing way too much echoes and wants to audit.

Every encounter is well documented and work done.

Any suggestions/comments?

Thanks.

 

[AmandaBriggs]

CMS has issued guidance that states that the POS should be assigned for wherever the patient received the face-to-face service. So, if the patient had an echo at a hospital as an outpatient, the correct POS for the physician's interpretation would be 22. It was included in Change Request 7631. Here is a link to the article:
https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/downloads/MM7631.pdf

 

[heartyoga]

Thanks Amanda. The procedure was done at another doctor's office and we read it in our office. So POS 11 Office is appropriate ?

 

[AmandaBriggs]

I would say, yes, that is appropriate based on the guidance from CMS.

 

[heartyoga]

Thanks !

 

[scuatro4]

as long as the 1500 CMS claim shows the correct location under box 32 the Service facility must indicate the other physicians office and box 33 should include your providers information. POS will be 11