Wiki Re: Place of Service...

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sassmile

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Re: Place of Service...

This question was sent to me... I am not sure of the answer... any help would be greatly appreciated:

Dr is an oncologist with offices on site in the hospital; his office is adjacent to the chemotherapy infusion area. The more I read the more I think we should be billing w/two POS's depending on what he has done. If no labs or any hospital services, should it be Physician office. If labs, scans, chemo performed on same date of service should it be Hospital Outpatient? Or should it always be physician office?
 
Yikes! This is always a debate we have. We bill for a clinic that is located in the hospital. We always bill as a Dr's office for his/her services. Anything else is billed by the hospital. Our Dr's also perform minor procedures on patients in the clinic and these are also billed by us as a Dr's office. Although we are a clinic, we do not meet the criteria set up in the descriptions for "clinic" therefor we have to bill as office.

Unless your doctor's office is set up as a clinic, you need to bill as office. Even if there are labs or other services ordered.
 
I am not sure I am understanding, is the clinic owned by the hospital? If so does the physician pay rent and his own staff and supplies? We had a physician office in the hospital clinic setting but the physician did not "own" any of the resources, therefore the POS was 22 for all of his encounters whether in his "office" setting or the infusion unit. We also had a physician that rented his space from the hospital and paid his staff and bought his own supplies, this was billed as POS 11 when seen in his office and POS 22 when in the infusion unit. I was always instructed that POS was dependent on ownership of the space.
 
POS and PROVIDER NPI

I am also looking for answers on how to bill for lab services ie a blood draw performed in the lab at the hospital where the clinic is owned by the hospital. I was told that I could bill for the lab on a HCFA if I use POS 22 and Provider NPI. I have been billing these labs on a UB w/POS 22 and Hospital outpatient NPI# and claims pay under the outpatient benefits. We are also CAH and RHC and Im not sure if this make a difference.
 
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