Radiology Coding Alert

Take time to read through the latest announcements from Medicare.

Medicare’s new place of service (POS) rule went into effect April 1, 2013, but a string of revisions means you need to stay alert to be sure you’re applying the most updated rule.

For imaging claims, the main point to remember is that the place of service code should reflect where the face-to-face service took place. That means providers performing the professional component of interpreting tests must use the POS where the face-to-face service was performed, such as an outpatient facility or ambulatory surgical center (ASC), says Catherine Brink, BS, CMM, CPC, CMSCS, president of NJ-based Healthcare Resource Management.

So if a patient has an imaging service performed at an ASC, but the radiologist interprets the image at his office, the radiologist’s claim for the interpretation should have the place of service code for the ASC (POS 24) and not for his office (POS 11).

Two exceptions relate to patients registered as inpatients (POS 21) or outpatients (POS 22) of a hospital. In those cases, you should always use the POS code for where the patient is registered.

To keep your claims in the clear, review the documents at the links below, and keep an eye out for announcements from CMS and your local MAC providing additional revisions:

·         MLN Matters:  www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7631.pdf

·         Transmittal 2679, CR 7631: www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2679CP.pdf.