Gastroenterology Coding Alert

Question: If you are billing home visits, 99341-99350, the place of service is 12. My question is what will appear in block 32 of the CMS-1500? Do I have to enter the patient’s address into my computer software database as a location, or can I make up a generic location in my database that just states: Patient Home, see block 5 on CMS-1500 for physical address?

Massachusetts Subscriber

Answer: If the location where your clinician is providing his services is other than your office, you will have to enter the proper physical address of the location where the services were provided in block 32 of the health insurance claim form (CMS-1500). Section 10.4 of Chapter 26 of the Medicare Claims Processing Manual instructs for block 32, “Effective January 1, 2011, for claims processed on or after January 1, 2011, submission of the location where the service was rendered will be required for all POS codes.”

You should enter the entire address and not make a mention of a generic location such as “Patient home” in this column. Also, you should not make a reference such as “see block 5” as you have mentioned in the question you have posed.

Also, it is mandatory that this information has to be completed regardless of whether your clinician’s services were provided at the office or any other location. If your clinician is providing his services in his office, then you will be just entering “Same” for this column and furnishing the information about the location of his services in “block 33” of the CMS-1500.

For more information, check the link at http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf.