Wiki Diagnostic Laboratory POS

SMatsu

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Hello!

I work for a diagnostic laboratory that receives punch bx's from providers all over the United States. I'm questioning whether POS 11 should ever be billed by an independent laboratory. I understand we have to match the POS the ordering clinician bills, but based on the Medicare description of POS 11, it makes no sense to me why we'd bill POS 11. I also found a commercial insurance guideline that states if the specimen was taken in an office setting or at an ASC, you would bill POS 81.

There are some carriers that will not pay for our CPT codes in an office setting and we're passing the bill onto the patient. I'm worried we're making our patients pay b/c we're not billing the claim correctly.

Is anyone able to clarify what POS should be billed when the bx is taken in an office setting?

Appreciate any information or guidance!
 
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