Neurology & Pain Management Coding Alert

Question: Our neurologist is the medical director of an acute care inpatient rehabilitation facility at a local hospital. We have been billing his claims with location code 21 (inpatient hospital) and have been reimbursed. Should we be billing with location code 61 instead?

Michael Mayron
Henderson, Ky.

Answer: If the patient was seen in the doctors office, location code 11 (physicians office) should be used, says Kathy Zmuda, CPC, lead inpatient coder for Cigna Health Care of Arizona. For patients seen in the acute care inpatient rehabilitation facility located at the local hospital, location code 61 (comprehensive inpatient rehab facility) would more accurately reflect the place of service. Accurate coding is especially important with Medicare claims due to the many audits Medicare is performing.

Patricia Niccoli, a coding expert from ElectroAge Billing, a multispecialty physician billing service in Phoenix, adds that the place of service codes should be added to box 24B of the HCFA 1500 form.