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Help place of service change

  1. #1
    Question Help place of service change
    Medical Coding Books
    We have changed from POS 11 to POS 22 and now have to refile claims. Can anyone suggest a where to begin?

  2. #2
    Location
    Columbia, MO
    Posts
    12,531
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    Why do you have to refile claims? were you suppose to always be a 22? how far back are we talking?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    Hi Debra thanks for responding.
    Its my understanding that we should have been POS 22 from the begining. We bought this practice and they automatically placed it as POS 11. We are looking at claims from July 2011 to Dec 2011. Any suggestions you can offer are greatly appreciated.

    Thanks again

  4. #4
    Location
    Columbia, MO
    Posts
    12,531
    Default
    yes you will need to rebill them all, and there will be refunds that will need to be made make sure documentation clearly supports all codes on the claims and they will need to be rebilled the same way they were billed initially, then if there needs to be any changes you can do a correction.
    I take it you are located in an outpatient setting then? you do not pay rent and your staff is paid by the facility?

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Default
    Hello,

    1) Have you already made the change to your system to reflect POS 22 rather than 11?
    2) You may be able to go back farther depending on the filing limits of the carriers for appeals. Check with each carrier on this.

  6. #6
    Default
    Thanks Ladies for respnding. I have been given this task and appreciate all help to correct it.

    @ekeylor we have made the change for 2012 but are not using a different system. So now I have the task of resubmitting thru the new system now and want to do it right the first time.

    @ Debra office is on site at the hospital and we all arepaid by the hospital.


    Is it true that now that we are POS 22 the claims needs to be filled on UB 04? They are referrring to all the injections/infusions/labs....this is going to be a task. Is there a book or website that i can refer to for this type of transition?

    Thanks again

  7. #7
    Location
    Columbia, MO
    Posts
    12,531
    Default
    when you are an outpatient clinic which essentially what you have, the provider can bill for those things a provider does like the E&M and physician performed procedures. The facility then bills on the UB the facility services, which is a facility E&M and things performed by facility personnel, the injections, drugs, IVs, labs, and the facility will also bill for the procedures performed by the physician to capture to overhead for the provision of the procedure. In a facility clinic the facility will use the 510 reve code for their charges.
    Does the facility have their own coding department for outpatient charges? or will you be doing both? some payers will allow the physician charges to also go on a UB with a different rev code which I think is 981 although it has been awhile so you will need to look it up, n that case the facility claim will have two charges for some things one with a 510 rev code and one with the provider rev code (981 if you will)
    This is probably very confusing, so first thing is to find out if you are responsible for the outpatient claim as well as the professional claim.

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    Default
    Debra yes this is very confusing...At this time i only have to deal with the outpatient claim the office mgr will process the professional claim. I tried to search online for a resources and found the Oncology/hematology coding campanion or the audio. Have you used either of these and do you think it will be helpful to invest in?

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