blue cross and place of service code for pathology report when patient was in the hospital

If the patient was an inpatient when the specimen was removed then we billed with place of service 21. If the patient was an outpatient at the hospital we are associated with then we bill with the 22 outpatient. We do have some cases where specimens are removed in a clinic out patient office and in those cases we use the 11 place of service.

Full Answer

What does it mean to code from the pathology report?

When CODING strictly from the PATHOLOGY REPORT, the coder is assigning a DIAGNOSis based on the PATHological findings alone without the attending physician's corroboration.' A patient comes into the hospital with a fracture of the femur. Upon discharge, the physician lists in his final DIAGNOStic statement, fracture of femur.

What is the CPT code for pathology lab billing?

Recently the pathology lab has been billing on a 1500 form CPT 84165 with a 26 modifier and 86334 with a 26 modifier under place of service 11 due to the patient was drawn at a physicians office. Medicare is denying.

What is the place of service code for a lab?

Place of Service Code(s) Place of Service Name Place of Service Description 81 Independent Laboratory A laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician's office. 82-98 Unassigned N/A 99 Other Place of Service Other place of service not identified above.

Can I use a POS 11 on a pathology lab report?

The technical work was not done at the physicians office. The technical work was done after the specimen arrived at the lab, so you wouldn't use the POS 11. The only person who might do that is the physician who obtained the specimen in his office. You are saying "pathology lab", but you are referring to the Pathology Group, correct?

What is place of service code 23?

Emergency Room – HospitalDatabase (updated September 2021)Place of Service Code(s)Place of Service Name23Emergency Room – Hospital24Ambulatory Surgical Center25Birthing Center26Military Treatment Facility54 more rows

What is place of service code 19?

Off Campus-Outpatient HospitalPOS code 19 is for “Off Campus-Outpatient Hospital.” CMS describes this as “a portion of an off-campus hospital provider-based department (that) provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or ...

What is place of service code 49?

Independent Clinic49 Independent Clinic A location, not part of a hospital and not described by any other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only.

What does place of service code 11 mean?

officePhysicians shall use POS code 11 (office) when services are performed in a separately maintained physician office space in the hospital or on the hospital campus and that physician office space is not considered a provider-based department of the hospital.

What is a place of service 22?

On Campus-Outpatient HospitalPOS 22: On Campus-Outpatient Hospital Descriptor: A portion of a hospital's main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.

What is place of service code 41?

Place of Service Description 41 Ambulance – Land A land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured. 42 Ambulance – Air or Water An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.

What is the difference between place of service 19 and 22?

Beginning January 1, 2016, POS code 22 was redefined as “On-Campus Outpatient Hospital” and a new POS code 19 was developed and defined as “Off-Campus Outpatient Hospital.” Effective January 1, 2016, POS 19 must be used on professional claims submitted for services furnished to patients registered as hospital ...

What is the difference between POS 31 and 32?

POS 32. Use POS 31 when the patient is in a skilled nursing facility (SNF), which is a short-term care/rehabilitation facility. Use POS 32 when the patient is in a long-term nursing care facility.

What is the difference between POS 21 and 22?

However, for a service rendered to a patient who is an inpatient of a hospital (POS code 21) or an outpatient of a hospital (POS code 22), the facility rate is paid, regardless of where the face-to-face encounter with the beneficiary occurred.”

What is the difference between POS 22 and 11?

I think it would be POS 11 even if it is owned by the hospital it is offsite and in an office. 22 POS to me is when a service is performed in the hospital and the patient is never admitted.

What is the difference between POS 02 and 10?

POS 02 has been changed to reflect patients who receive telehealth in locations other than their home, and POS 10 has been added to reflect patients who receive telehealth in their home.

What does POS 02 represent?

According to CMS, POS 02 is defined as “the location where health services and health-related services are provided or received, through a telecommunication system.” CMS has replaced the GT modifier with POS 02. POS 02 can be used when billing CMS claims for synchronous telemedicine visits.