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POS Question

  1. #1
    Location
    St. Louis West Missouri
    Posts
    31
    Default POS Question
    Medical Coding Books
    We have been using a POS of 22 for hospital patients that are observation only. Should we be using a POS of 23? We have been getting denials from Essence and Secure Horizons for no auth/precert or no referral since the Medicare changes went into effect.

  2. #2
    Location
    Kansas City, MO
    Posts
    431
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    Observation department is considered OUTPATIENT. You are right in using 22. I'd give those companies a call and ask them whats going on. I'm not personally familiar with those plans, but do they require any sort of notification?
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC,CCC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    President, 2018
    Vice President, 2017
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

  3. #3
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Quote Originally Posted by MAult142 View Post
    We have been using a POS of 22 for hospital patients that are observation only. Should we be using a POS of 23? We have been getting denials from Essence and Secure Horizons for no auth/precert or no referral since the Medicare changes went into effect.
    I agree it is POS 22. I am curious as to why you would think 23 though. Observation is a physician order for observation status. Any bed in the facility can be an observation bed. So even if the patient is physically in the ER, once the physician writes the order for observation status, it becomes an outpatient status.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    St. Louis West Missouri
    Posts
    31
    Default
    At this point, we're just grasping at straws. We didn't think it was 23 but we thought we'd put it out there just in case. Thanks for your responses!

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