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READER QUESTION:

Find the Key to Your Prison POS Question

Published on Thu Nov 16, 2006

Question: What place-of-service code should I use if the doctor provides services at a prison?


Maine Subscriber
Answer: CMS added a place-of-service code for prisons, effective July 1, 2006, and implemented Jan. 2, 2007:

• 09 Prison-Correctional Facility (July 1, 2006) -- A prison, jail, reformatory, work farm, detention center, or any other similar facility maintained by either federal, state or local authorities for the purpose of confinement or rehabilitation of adult or juvenile criminal offenders (Medicare Claims Processing Manual, Chapter 26, Section 10.5). Warning: CMS is very clear that just because this code exists, it doesn't mean Medicare will pay for services at prisons.

For more information, see the MLN Matters article MM4316 "Update to the Place of Service (POS) Code Set to Add a Code for Prison/Correctional Facility" at
www.cms.hhs.gov/MLNMattersArticles/downloads/MM4316.pdf. Or see the official instruction CR4316 at www.cms.hhs.gov/Transmittals/downloads/R1049CP.pdf. The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.
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