Medical Billing Forum
Billing => Billing => : billbill September 02, 2012, 03:47:04 PM
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I am considering taking on a new client but I have a question. The provider is a non-physician owned IDTF (radiology). They have been billing in-house using POS code 11 because the radiologist is on-site. However, I feel that they should be using POS code 49. They disagree. its important because some of the insurance companies will pay allowable less a specialist copay for physician office but POS 49 will pay outpatient testing fee schedule. That makes it harder to get patients to schedule testing because it costs them more. Some of the insurance companies have caught onto this and process all claims correctly no matter what POS they indicate. However, some of the insurances still pay specialist benefits. So does having a radiologists onsite qualify for 11 POS code or is 49 correct?
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Where is the testing being done? Does the IDTF travel to the dr's offices and perform the tests or do they have their own site that patients actually physically come to?
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Testing is being done on-site (IDTF). We do have a full-time radiologist here as well.
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Check out the following Medicare Regional Carrier page on IDTF POS's:
http://wpsmedicare.com/j5macpartb/resources/provider_types/idtf_faqs.shtml