Medical Billing Forum

General Category => General Questions => Topic started by: am1976 on March 29, 2011, 07:04:09 PM

Title: Place of Service Coding
Post by: am1976 on March 29, 2011, 07:04:09 PM


I bill for professional services and I need to know if I am coding correctly the Place of Service.

The doctor is contracted with the hospital and works in a clinic owned by the hospital. The clinic is not inside the hospital but is only a couple blocks away.  I bill the following to Medicare:

CPT 99183  and POS 22 Out/PT in a hospital setting.  Is this right? If not what should I do bill office POS 11?

Also, should I notify Medicare if I have been billing incorrectly. I've been doing this for more than two years now and never had a problem. Will this make a difference in payment?  The hospital being the owner of the clinic bills for facility.

Thanks in advance for your help!

Clueless Biller hoping not to get fired . . . :'(
Title: Re: Place of Service Coding
Post by: Michele on March 30, 2011, 06:59:13 AM
99183 is for hyperbaric chamber, is that what the clinic is?  Are you billing under the hospital name and EIN/NPI?  It really depends on how you are billing (under hospital name) and how the insurance carriers have you on their provider files.  If you are 'part of' the hospital then the 22 would be appropriate but if you are a stand alone clinic, set up that way with insurance carriers then the 11 may be correct.

Need more info to be sure.