With Code 21 – It’s Location, Location, Location!

As you know in processing medical billing for hospital based claims, location of services is everything and you must be certain that the correct place of service coding is used. That is where code 21 comes in handy. Place of service code 21 is used in medical billing for all inpatient hospital care. Code 23 is a lesser used code, but also useful.

Admittance of a patient to the hospital will make it necessary to use the inpatient hospital POS code 21. Many medical billers get confused when the emergency department comes into play. They question whether or not they should use place of service code 23 for emergency room-hospital, or place of service 21 for inpatient hospital if a patient is admitted from the emergency department. This becomes confusing when a patient is brought into the emergency room, taken into surgery, and then admitted after surgery. It is obvious the location after surgery should be POS code 21, but what about before the patient was admitted?

Fortunately the answer is simple. Medical billing hospital admission codes include absolutely everything that was done on that particular date of service. This means anything a physician does to a patient in the emergency room is included with everything a physician does once a patient is admitted on that day. So, Place of service code 21 should be used in medical billing for the entire day that a person is admitted.

The only time POS 23 is used is if the patient is not admitted to the hospital. POS 23 would be used for all services rendered on that day in the ED, including surgery as long as the patient wasn’t formally admitted. Make sure you use the proper POS code and reap the benefits on your reimbursements.

Make sure documenting your POS correctly in your medical billing and attach code 21 and 23 as necessary and you’ll see your reimbursements go up in a healthy fashion.

View all Articles by: Melissa Clark, CCS-P