Getting Place of Service (POS) Codes Right

For correct payment amount, accurate place of service codes are required. The failure to provide the correct place of service code with the correct current procedural terminology code for E/M services will cause your claim to get denied. One of the most important elements of medical billing is the place of service code.

In medical billing, the place of service codes for an evaluation and management are commonly misused. 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 medical place 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, the correct POS code would be Medicare Contracting Changes Could Bring Reimbursement Delays
When billing to Medicare, expect some medical reimbursement delays in the upcoming years. The Centers for Medicare & Medicaid Services is currently reforming contractor workload for medical billing claims that come in. The speedy implementation of this medical billing reform may lead to reimbursement delays and errors.

Congress mandated that the Centers for Medicare & Medicaid Services reform their contracting system. This needs to be completed by October of 2011. However, since estimates of huge savings have been made, the Centers for Medicare & Medicaid Services wants to speed up this medical billing contractor reform. Their goal is to have it completed by 2009, which is two years earlier.

This change to the contractor method will take many Part A and Part B contractor work loads and transfer the loads over to the Medicare Administrative Contractor. Unfortunately, by making this reform too soon it is very likely that medical bills will be reimbursed incorrectly or with much delay. It seems as though the Centers for Medicare & Medicaid Services has not thought of possible medical billing and reimbursement problems of implementing this system too soon. The Government Accountability Office has suggested to CMS to wait until 2011, but they have refused.

If your practice is planning on billing Medicare in the coming years, it would be wise to keep close track of those medical claims. Make sure they are not lost in the cracks. Also be sure they are reimbursed at the correct rate. This extra effort could become a headache for your practice. Medical Billing firms can alleviate this stress. Their job is to make sure your claims are paid on time and accurately. They know how to deal with payers. Medical billing companies can save your practice much headache once Medicare makes contracting reforms.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 erase this problem from your mind. Medical billing companies are versed in the correct billing procedures for every medical service. They check claims for accuracy before they are submitted and take care of any claims that come back unprocessed. Correct medical billing POS codes are essential for maximum practice profitability.

View all Articles by: Melissa Clark, CCS-P