Wiki POS Question

[MnTwins29]

Our urgent care centers use 20 as the POS code for most claims. One carrier changes it to 11, as they do not recognize 20 as a "covered" place of service for thier beneficiaries.

Some of these beneficiaries, even though they are not supposed to do this, use one of the care centers as their PCP, and the doctors may do work that is typically done in the office. One of our administrators is asking if they can use 11 as the POS for these patients since the service is an "office" service and the payer is requiring it. I am certainly NOT comfortable with giving that advice, and I was wondering if anyone else has had a similar situation.

Thanks in advance!

 

[Walker22]

I have a question. Do you allow patients to make appointments or do you work on a first come first serve basis? The reason I ask is that if you read the definition of POS 20 it specifically says "unscheduled" patients. I would think, therefore, that if you allow patients to schedule appointments then you can use POS 11. If not, then you must use POS 20.

 

[MnTwins29]

No, there are no "scheduled" patients as these are urgent care centers. But just like how some patients without a PCP use the ER like one, some patients use the care center like a PCP. Thank you for your input!