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POS Codes

  1. #1
    Indianapolis, IN
    Question POS Codes
    Medical Coding Books
    This seems like a simple issue and maybe I'm overthinking it, but I'd like a second opinion. I recently started doing billing for a surgical practice. They see patients "in clinic." The prior biller used POS code 11 -office - (Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.), as this is the only "office" they use. The office is actually a section of the hospital that they share with other practices. We rent the space on certain days, and other departments rent it on other days.

    I'm wondering if this is actaully a POS code of 11, since it is located within the hospital. Would it not be considered outpatient, (A portion of a hospital which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.)

    How can I tell for sure?
    Thanks in advance for your help

  2. #2
    Columbia, MO
    Do you actually rent this space? or is it just designated for your use on certain days. The reimbursement is different for a POS 11 from a POS 22. to use the POS 22 then the ancillary staff used is the facility's, meaning they are paying the salaries not your physician. The drugs used are purchased by the facility and you do not reimburse them. So look closely at the arrangement. If the staff (all your staff) is paid out of the physician pocket and you are paying rent to cover the space and utilities and any drugs you use are purchased by the physician then this is an 11. IF you just use the designated space and use the facility staff for the RNs and everything else then this is a 22.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Indianapolis, IN
    Actually, I think they bring their own staff and use some of the hospital staff. I'll definately check into it more closely.
    Thanks for your help!

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