Identify five places of service codes that may be reviewed for an audit. Explain why the place of service and the procedure code need to correlate for appropriate coding and billing.
What will be an ideal response?
In addition to answering the question, have students apply place of service codes to their practice. To check current codes, go to the Medicare Web site at www.cms.gov, and click on regulations and place of service codes.
1. 11= office
2. 12= home
3. 13=assisted living
4. 20=urgent care
5. 21=inpatient hospital care
6. 22=outpatient care
7. 24=ambulatory surgical center
8. 31= skilled nursing facility
Many CPT codes are specific to a health care setting, such as Evaluation and Management codes (E&M), to office or hospital.
If patients are seen in a facility, the codes that are specific to that facility must be used, such as Inpatient Hospital visits with POS 21.
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