Some charges can be performed at more than one location. Some charges would logically be performed at one location but not at another. Insurance Carriers data-mine their electronic data to find out how many of each charge is performed at each location. They also do edits, and reject charges that are performed at non-natural locations (a colonoscopy wouldn't logically be performed at a school, so an edit would likely reject that combination). So - we see that Insurance carriers want a POS connected to each charge submitted, for the purpose of data mining and for the purpose of edits.
Is there ever an instance where there would be two transactions in box 24 and each of them have a different POS. I can't think of a situation where that would happen. This makes me wonder why the POS code is on each line item ...
Our billing software is set up so that Box 32 is linked to Box 24b. What the software places into Box 32 depends directly on what is in Box 24b. The fallout of this is that only items with the same Code for Box 24b show up on the same CMS 1500 form.
Assume we have put into the billing software 15 different charges for a specific doctor, five charges each at three different locations (this does happen with some of our clients). The software sorts the 15 charges based on the code in Box 24b (or we can sort manually). After sorting, we end up with three groups of five charges. For example, five charges all coded "11" (office); five coded "21" (inpatient hospital) and the last five coded "24" (ambulatory surgical center).
All five charges with the same code in Box 24b and location in Box 32 go on one CMS 1500 form; the next five charges with the same but different code in Box 24b, and different location in Box 32, go on a different CMS 1500 form. And the same for the last five charges with the same but different code in Box 24b. (All "11"s on one form; all "21"s on another form; all "24"s on the last form.)
We need a code in Box 24b for each charge to be able to do this. That code is actually entered into the billing software when the charges are entered. Our software allows us to attach a default POS code to each CPT. When we type in the CPT code, the default POS shows up, but it can be changed if necessary.
So - your basic premise is correct. Since only those charges that have the same POS code show up on a given CMS 1500 form, there could be just one box that shows this POS code per CMS form - so far as you or I are concerned. However, the Insurance Carriers want the POS code attached to each charge, for their own purposes. So we end up with the CMS 1500 form designed the way it is.
If you know database design, you know the concept of records and fields. For electronic billing, the concept of lines is irrelevant. We simply know that the software is designed to put the proper POS field into the same record as the CPT code field when it is submitted to the Clearinghouse. But for paper,
each line that is scanned will be turned into a seperate electronic data record. Therefore, in order to be contained in the same data record as the CPT code, the POS field needs to be
on the same line as the CPT code field. So again, we end up with the CMS 1500 form designed the way it is.