Author Topic: POS 22 vs 11  (Read 2789 times)

midwifebiller

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POS 22 vs 11
« on: July 13, 2009, 10:11:11 AM »
I got this email this morning:
 
I work in a hospital-based midwifery practice. We are in a  freestanding building but located on the hospital campus.The business office in our hospital codes all antenatal services under POS 22 (outpatient hospital) vs. POS 11 (office visit). As a result, our insured patients are getting bills for the new ob visit, ultrasounds, etc(anything not covered under the global fee is being charged as an outpatient hospital visit rather than an office visit). Just wondering if there is anyone out there who can speak to this issue. The business office tells me that they are legally compelled to code with POS 22 and nothing can be done about it. Surely, just because a patient visits a hospital midwife doesn't mean that she is not eligible for her maternity benefits? Any experience, advice, etc would be greatly appreciated.

Since they are in a freestanding building, I think they should be billing with POS 11. Please comment.

~Kelli
Midwife Billing & Business, LLC
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

PMRNC

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Re: POS 22 vs 11
« Reply #1 on: July 13, 2009, 04:40:41 PM »
Be careful how you answer this as they have already referred to their legal department.
With only looking at a glance, if the charges are being done outpatient you can't change the POS to 11 for reimbursement purposes (or any other coding for that matter). Now if your facility is properly setup with their own numbers that is different and you would be able to use POS 11, but without knowing how your facility is setup it's hard to advise.
Linda Walker
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midwifebiller

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Re: POS 22 vs 11
« Reply #2 on: July 14, 2009, 07:47:04 PM »
Thank you for your response. I asked them about their numbers, but have not heard back. Perhaps they were able to get a response from another source.

~Kelli
Midwife Billing & Business, LLC
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com