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Tara0513

Networker
Messages
32
Location
Colts Neck, NJ
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0
Hello Fellow Coders-
I work for an independent lab (POS 81) when we are submitting our claims, what POS should we be using? We have been using POS 81 because this is where we are processing the specimen that is sent to us from either an Urgent care, ambulatory surgical centers or physicians office. We have been receiving denials (primarily United Healthcare) specifically for Covid swabs. I have been researching and racking my brain and I am coming across some articles stating that the lab should be using the POS of where the specimen was obtained. I am so confused over this, why would we use a POS that is not associated with our lab? We are billing for the processing of the specimen, the processing is taking place in our facility 81, why would we use any other POS?

Is any other lab having this issue? Have you been able to rectify and get payment? Did you change POS to where the specimen was obtained?

I really appreciate any feedback. Thank you!!
 

Sarahlukkarila

Contributor
Messages
10
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0
Yes, UHC is notorious for it. I work for an OON lab too and coding guidelines say POS rules can be basically made up by payer policy. I think they use it as an excuse not to pay.
 

Tara0513

Networker
Messages
32
Location
Colts Neck, NJ
Best answers
0
I have a feeling they want place where specimen was obtained. Its getting out of hand now. Its insane, we are being inundated with medical records denials.
 
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