Medicare and POS 13 (assisted living)

[Christy]

Can someone please help me.

I bill for a nutritionist- she uses cpt 97802 and 97803 only.

She recently went to an assisted living facility and saw three patients.

According to Medicare, these CPT codes are compatible with POS 13.

But, do we have to file an 855I showing this as a practice location? I think that she plans to visit other assisted livings too.

Or will Medicare accept the claim with POS 13 and the assisted living facility address in box 32? And the provider's info in box 33.

If so, what would we put in box 32a and 32b?

thanks so much!!!!
Christy

[kristin]

You don't need to do an 855 for this, at least not that I have ever heard of.

In Box 32, you will put the name and address of the facility, then in Box 32a, you would put the organizational NPI of the facility. You can either get that from them, or look it up on NPPES, but makes sure it is correct, or you will have issues. Nothing goes in Box 32b, unless a specific qualifier is needed by the payer...and in the case of my MAC, and other MAC's I deal with, nothing is needed there.