trarut
True Blue
This question is geared to physician billing. We recently received a denial for a radical hysterectomy citing an invalid place of service. We billed it as outpatient and have confirmed this with the hospital where the surgery was performed. One of my coders was told by a rep at one of the local hospitals that they've suddenly had many denials for the same reason and I had a call from a peer at another practice with the same problem, also on a radical surgery claim. The payers denying are Medicare and Medicaid plans. We've been reviewing past updates from the payers to see if we missed a POS change but can't find anything.
So my question: is anyone else experiencing unexpected denials like this, where the POS is correct, or have you heard of any major POS changes that went into effect in the last 2-3 months? I'm wondering if there was a change on the facility side that's being applied inappropriately or having a trickle down impact on the physician side.
Thanks in advance,
Tracy
So my question: is anyone else experiencing unexpected denials like this, where the POS is correct, or have you heard of any major POS changes that went into effect in the last 2-3 months? I'm wondering if there was a change on the facility side that's being applied inappropriately or having a trickle down impact on the physician side.
Thanks in advance,
Tracy