Wiki Obs Codes: Invalid Place of Service

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MandyML

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I am very new to billing IM and am having issues getting MC to pay for Obs codes. I am billing 99220 and 99217 no mod, with a place of service of the Hospital the patient is at. They are being denied for Invalid place of service. From what I have read I need to change the location to outpatient 22? Is that right? Unfortunately our software doesn't allow me to go in and change it so I will need to contact them if thats the case. Do I need modifiers?

Thanks!
 
Your POS is 22 for outpatient, what do you mean your software does not allow you change it? This is a filed that should be available for you to populate always. When you say you are using the place of service of the hospital the patient is at, empirically this is correct because that is a 22, the Hospital NPI and address goes in field 32 and 32A, the POS is in field 24 column C I think it is.
 
The software the doc is using is NOT user friendly or effiicient. I found out the the hospital was set up as an Inpatient 21, I added a new set up for Outpatient 22 and rebilled. We will see if that works!

Thanks!
 
That should work for you, but you must also look at how the hospital billed, the place of services must match or your claim will be denied again.
 
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