Question: If I’m coding for the PC of a test performed in an outpatient hospital, do I use the POS of where the cardiologist interpreted the test (office) or the outpatient hospital?
Connecticut Subscriber
Answer: Because the face-to-face part of the service happened at the outpatient hospital, that’s the POS you should report. Choose between POS 19 (Off campus-outpatient hospital) and POS 22 (On campus-outpatient hospital) for the outpatient hospital POS.
Support: In Medicare Claims Processing Manual, Chapter 12, Section 150, you’ll find a statement that “As a general policy, the POS code assigned by the physician/practitioner for the PC of a diagnostic service shall be the setting in which the beneficiary received the TC service.”
Medicare provides exceptions to the general policy. If the beneficiary is a hospital inpatient or outpatient, always report the inpatient or outpatient POS, regardless of the actual setting of the technical and professional components.