Author Topic: Place of Service for Pathologist  (Read 2347 times)

tomtom2

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Place of Service for Pathologist
« on: August 27, 2008, 11:10:47 AM »
If you are a hospital based pathologist (you never leave the hospital) and a specimen is sent to you from a doctors office. What is the correct place of service the pathologist should report? 11-doctors office or 22-outpatient hospital? Keep in mind we are not a 81-independent lab and can not bill as such.

Thanks,

Michele

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Re: Place of Service for Pathologist
« Reply #1 on: August 27, 2008, 03:35:11 PM »
I haven't personally come across this before but I did a little research.  The research points to the place of service should be the place the specimen was obtained, so in your example, 11 for office.

If anyone has any other info on these, please comment.

Thanks
Michele

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tomtom2

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Re: Place of Service for Pathologist
« Reply #2 on: August 28, 2008, 09:37:12 AM »
I've been researching this for over a month now and see why 11 for office would seen to been correct. But a handful of codes the pathologist bills for get higher payment for the office POS. Because they assume in your office you have additional expenses (rent, equipment,....), Rather than a facitily POS were the facility itself gets separate payment. I don't want to recieve any overpayments, but I want to bill the right POS.

Michele

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Re: Place of Service for Pathologist
« Reply #3 on: August 28, 2008, 09:49:03 AM »
What I would recommend is calling one of the provider reps for a larger insurance carrier in your area and ask them how they want it billed.  That should clear it up, and they usually will be able to explain their reasoning to you.  We have done this in the past on similar situations and it has helped tremendously.  Most insurance carriers use the same guidelines for situations like this so picking one of the larger ones is usually good.

Let us know what you find out.

Thanks
Michele
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tomtom2

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Re: Place of Service for Pathologist
« Reply #4 on: September 18, 2008, 08:58:06 AM »
Florida Medicaid informed me that correct POS should be 22 outpatient.

Michele

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Re: Place of Service for Pathologist
« Reply #5 on: September 18, 2008, 12:57:23 PM »
Well, that clears it up.  Isn't it amazing how much room for interpretation there is out there in the world of billing.

Glad you were able to find out.

Michele
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kbolt

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Re: Place of Service for Pathologist
« Reply #6 on: September 23, 2008, 02:20:46 PM »
We do billing for a hospital based pathologist and we use the POS 11-for doctors office. We have never had a problem and we have been doing the billing for a very long time now.


tomtom2

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Re: Place of Service for Pathologist
« Reply #7 on: September 23, 2008, 03:14:44 PM »
I also spoke to Joan Logue who will be presenting on this subject in Dec at Orlando. She also stated the correct POS would be 22. Now I also have Dennis Padget (in a email) stating that it is long standing convential wisdom to use the POS were the patient is. That is fine if you are considered a independent lab and get paid on a different fee schedule. But this is just my interpretation. Please see the below website. I welcome feed back as I have been working on this for a couple of months now.

Thomas Simpkins CPC


https://www.codemap.com/content.cfm?d=04/01/2005%20Place%20of%20Service%20(POS)%20Codes&id=2440