Wiki Question for POS codes with E/M changes relating to assisted living facility visits

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MagenD

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Joliet, IL
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Hello, I have charges that are being stopped by our clearing house for invalid place of service codes but I am not sure how to go about correcting this. Maybe I have misunderstood the new coding updates for assisted living, but since the codes we used to use (99334-99337) have been deleted, we are now supposed to use what used to be home visit codes (99347-99349) as the definition has been updated to include assisted living, independent living, and group homes. I have used this CPT for these charges with the place of service code 13 for assisted living facility (which from what I have read would be the appropriate way to bill these?) but now our clearinghouse is rejecting these claims saying the POS is invalid. So I have tons of claims that are just stuck in limbo....
Anyone have any insight on this? I'm thinking I might need to contact our clearing house about these updates but I want to make sure my understanding here is correct first
 
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Hi there, the AMA and Medicare have confirmed that there was no change to the POS codes you should report. Unfortunately it appears that some payers and MACs failed to update their systems to account for the code changes by Jan. 1. For a private payer you'll need to reach out to your account rep. If you aren't having any luck with your MAC try your CMS regional office.
 
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