You have several issues so I will address each of them separately. First, when the pathologist goes to the derm office and performs the frozen section you will bill the Medicare in the state where the procedure was performed. So if the derm office is in Illinois, bill Illinois Medicare.
Your second question is pos - if the lab is in derm office bill pos 11 and address in block 32 is the derm office address.
Third - Tissue (I'm assuming, not slides) is then sent to your lab in Missouri. Is the group hospital based or does the group have an independent lab. If the group is hospital based, Medicare rules state the place of service should reflect the location where the procedure was performed. So since the specimen was sent from an office the pos should be 11. If you group is registered with medicare as an independent lab then the correct pos is 81.
4th The pathologist performs a frozen section at the hospital. The correct pos would be the same as what the hospital used for the patient. So if the patient is inpatient you would bill pos 21 and if the patient is outpatient pos - 22.
Hope this helps.
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