Billing > Billing
Medicare POS?
RichardP:
POS 13, her NPI in Box 24J, and nothing in Box 33a.
I know that this works when POS is 12. I have no experience with POS 13. But an assisted living facility is "home" for the folks who live there. Which raises the question of whether one could get away with using POS 12 if they include the patient's room number in the address at Box 33.
Edit: I just re-read the discription of POS 12: Location, other than a hospital or other facility, where the patient receives care in a private residence. That description doesn't fit this situation.
Merry:
Are you talking about a dietician? Medicare only covers for certain diagnosis. If the patient is in an assisted living facility who is the medical provider (dietician) counselling? In this scenario doesn't the facility supply the food?
Merry
Christy:
yes, a dietician. Yes Medicare covers with a dx of diabetes or chronic renal failure. The dx is payable. The provider billed some claims as POS 11 when they were actually provided at the assisted living. They all came back paid, except this one, which was denied for invalid POS. The claim was pended for a very long time. Is it possible that the patient was questioned by Medicare re: where the svcs were rendered? He is legally blind.
I am trying to help her do this correctly going forward. The CPTs 97802 and 97803 are allowed at POS 11, 12, 13.
But is there some sort of permission needed from Medicare for the nutritionist to travel to the assisted living and see people? This happened before I came on board, but I think that one of the administrators at the assisted living just called her (the provider) up and lined up patients for her, ugh.
Merry- VERY interesting point about the assisted living providing food. The provider did mention that there is a place next door that sells ice cream, junk food etc. and the residents walk over there and buy it, lol!
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