Ok, for scenario #1, I have a question. Is the physician in a hospital-owned practice, where the office setting would be considered outpatient hospital...in other words, do you bill provider-based? Or, does the physician pay rent to the hosptial for his own private office? In the first case, bill POS 22. If he pays rent, bill POS 11, because technically, the patient has "left" the hospital to go to into the private office. The doc still has to be paid py the payer based on his office's physical setting; it wouldn't change to outpatient hospital just because of the patient's status.
For scenario #2, because the patient remains in a hospital setting when he leaves his bed to go to another hosptial department, the POS would continue to be 21, because he's still admitted and still physically in a "hospital" department. In this case, patient status determines POS.
I've clarified this with CMS recently, because we have had similar situations. Good question! Pam
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