Wiki POS Question

[MAult142]

We have been using a POS of 22 for hospital patients that are observation only. Should we be using a POS of 23? We have been getting denials from Essence and Secure Horizons for no auth/precert or no referral since the Medicare changes went into effect.

 

[LindaEV]

Observation department is considered OUTPATIENT. You are right in using 22. I'd give those companies a call and ask them whats going on. I'm not personally familiar with those plans, but do they require any sort of notification?

 

[mitchellde]

We have been using a POS of 22 for hospital patients that are observation only. Should we be using a POS of 23? We have been getting denials from Essence and Secure Horizons for no auth/precert or no referral since the Medicare changes went into effect.

I agree it is POS 22. I am curious as to why you would think 23 though. Observation is a physician order for observation status. Any bed in the facility can be an observation bed. So even if the patient is physically in the ER, once the physician writes the order for observation status, it becomes an outpatient status.

 

[MAult142]

At this point, we're just grasping at straws. We didn't think it was 23 but we thought we'd put it out there just in case. Thanks for your responses!