Author Topic: Coding for Place of Service 12 (Private Residence)  (Read 1382 times)

Csinsay

  • Newbie
  • *
  • Posts: 11
Coding for Place of Service 12 (Private Residence)
« on: September 21, 2010, 12:53:55 PM »
I have a question regarding when the doctor is providing services at the patient's private residence - Place of service code 12.  However, when the doctor performs E/M services, shouldn't the procedure code correlate with the POS.  For example, instead of using 99201 - 99215 (Office or Other Outpatient Services), the doctor should be using 99341 - 99350 (Home Services), correct?  Also, does anyone know the insurance reimbursement difference between POS 11 as opposed to POS 12?  Thanks!

oneround

  • Full Member
  • ***
  • Posts: 227
Re: Coding for Place of Service 12 (Private Residence)
« Reply #1 on: September 21, 2010, 03:24:26 PM »
Correct, you E/M code should catogorize by the POS.  Services performed in a private residence s/b reported with the code range of 99341-99350.  Also, It is my understanding that reimbursement is based upon the CPT billed and not the POS unless services are done in an OP or IP basis in wahich services are considerec on APC or DRG rates
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

Csinsay

  • Newbie
  • *
  • Posts: 11
Re: Coding for Place of Service 12 (Private Residence)
« Reply #2 on: September 22, 2010, 11:02:46 AM »
Thanks for your reply, Michael!