Wiki LICSW in school "office" setting

[bfieldfarm@yahoo.com]

Anyone out there bill for an licsw that goes into the school as an independent licsw for psychotherapy?? POS issues have come up with one payer because I have always been told to bill pos 11 because she is in an office - in the school building therefor it was still outpatient office therapy. I did not know but her "hand written" notes as she refuses to use a computer program she was saying "School" they did not take money back for this discrepancy in an audit but told us to refer to the POS charges yada yada. I still stood by that she was in an office and that was what her notes should say as when I started this work I researched this a lot and that was what i found. She refused my reasoning and told me to put POS "03" for school for the billing where she was in the school "office". Now this is independent psychotherapy where the schools allow her to use an office because many of the kids can not get to her office NOT school based therapy., ALL the claims with 03 denied. JUST like I thought. Anyone out there run into POS issues similar to this?

 

[Pam Warren]

"Office" means provider practice, not school, business or other office setting. The reason for this has to do with practice expense RVUs which are factored into professional charges. That, and correct coding. So you are absolutely correct in your reasoning.

However, if this is a commercial insurance plan, and they want you to use POS 11, then I'd do so in order to bill according to their guidelines as was agreed upon when you were credentialed with them, but get it in writing.