Urology Coding Alert

Fingertip guide to 5 POS codes eliminates confusion

Choosing the correct place-of-service (POS) code for your claims is essential to avoiding denials and even investigation for fraud. Keep on your auditor's good side by choosing your code based on these descriptions, straight from CMS.

• 11 (Office) -- Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, state or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis. Fair-market value for the office must be paid for this office in order to qualify for an office and POS 11.

• 22 (Outpatient hospital) -- A portion of a hospital that provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. Observation uses POS 22 even if the patient is in an inpatient bed (but in observation status).

• 31 (Skilled nursing facility) -- A facility that primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital.

• 32 (Nursing facility) -- A facility that primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than mentally retarded individuals.

• 33 (Custodial care facility) -- A facility that provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component.