Wiki 2023 OBSERVATION AND POS

[michelledc]

Now that we use the inpatient codes for observation, which place of service would we use? If it's observation (outpatient), but we use an inpatient code, won't it deny if we use pos 22?

 

[bgrasson]

If its outpatient POS 22 even for 99221-99223 and 21 for inpatient 99221-99223- its best to speak to the reps if they keep denying

 

[tlfoxworthy@gmail.com]

We have been getting denials from several different insurances when we use POS-22 with observation patients and the 99221-99223 and 99231-99233. Management is searching for the answer. Anybody else having this problem?

 

[PLDalsoren]

We are getting the same denials when we report POS-22 with CPT codes 99221-99223 and 99231-99233. I called UHC and they were no help. They said to submit a claim reconsideration. I looked up their own medical policy that states what codes to bill effective January 1st and submitted that along with an explanation of the rule changes. If that denies I'm taking it to provider relations and complain. It's ridiculous that they haven't updated guideline changes that were released months ago. Total waste of our time arguing with them...