AAPC - Back to school
Results 1 to 4 of 4

Thread: Place of Service

  1. #1
    Join Date
    Apr 2007

    Default Place of Service

    AAPC: Back to School
    Our office keeps getting denials for invalid place of service of 22 with therapeutic injections 96372.

    Does any one have any suggestions?

    Thank you,
    Tiffany Fischer, CPC, CEMC

  2. #2


    96372 is the stick and 22 is for outpatient. Since you said "our office..." I'm guessing that you're doing this in your office, and in that case, 11 is the POS code.
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

  3. #3
    Join Date
    Apr 2007

    Default Place of service

    But the office is considered an "outpatient clinic" that is why the office is always billed with 22 POS. I guess we don't understand why this place of service is being denied with these injections, and no other charges.

    Tiffany Fischer, CPC, CEMC

  4. #4
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    So - are you "provider based"? In other words, does the hospital bill a clinic charge, etc., on a UB04 claim? If you are not considered an outpatient department of the hospital, you should be billing with POS 11 for office, even if located on a hospital campus. If you are billing with POS 22, reimbursement for your services is based on facility, not non-facility Medicare fee schedule. In addition, any diagnostic tests would have to be for interpretation only, or they will deny. The 96372 can't be billed by a physician/NPP in a facility setting, as the facility should charge for it (we do have some clinics that are provider-based). If you give an injection into a joint (20600-20610) for instance; you charge the professional portion, the hospital charges a fee, and the hospital charges for the drug that was injected (Kenalog, etc.)

    If you are not an OP department of the hospital you should use POS 11.

    I hope this helps.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

Similar Threads

  1. Place of Service
    By 574coding in forum Outpatient Facilities
    Replies: 1
    Last Post: 06-10-2014, 06:20 PM
  2. Site of Service / Place of service for professional claims?
    By Denise in forum Outpatient Facilities
    Replies: 0
    Last Post: 03-14-2012, 05:41 AM
  3. Place of Service and Date of Service
    By NESmith in forum Billing/Reimbursement
    Replies: 1
    Last Post: 10-07-2011, 08:52 AM
  4. Place of Service
    By wahmcoder in forum E/M
    Replies: 0
    Last Post: 09-16-2009, 01:49 PM
  5. Place of service 61
    By wheezer in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-06-2009, 02:03 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.