Using Place of Service Codes Correctly

More and more carriers are cracking down on medical billing claims that have a lack of or incorrect place of service code. Even with the correct current procedural terminology code for E/M services, a medical billing claim that does not have a correct POS code will get your claim denied.

It is a common occurrence in medical billing for the place of service codes to be misused or left out. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 (which means the same as 99341 except with an established patient), the only POS code available for use is 12. This means home.

Many billers get confused with these places of service codes. If a patient is in an assisted care center, many people consider this a home and bill with place of service code 12. This would be incorrect. POS 12 is reserved for house, apartments, etc visits. There is actually a more specific code for an assisted care center in medical billing. It is POS 13.

Basically, for every current procedural terminology code, there is a correct place of service code that corresponds to it. If these medical codes are used incorrectly in billing, it will cost your practice time and money. Insurance companies will deny the claims and your office will have to correct the problem. With the use of an outside medical billing company, you can eliminate this problem. When you partner with a medical billing company, your claims are checked to make sure the correct billing procedures are used for every medical service performed and they check claims for accuracy before they are submitted. You will see your denial rate drop off and your reimbursements will arrive faster than ever before. Make sure you’re maximizing your reimbursements with the correct POS codes.

View all Articles by: Melissa Clark, CCS-P