what POS for doctor supplying Mirena when patient is in facility?

[eutsler]

The patient is in a Comprehensive Inpatient Rehabilitation Center. Insurance paid the provider for the insertion, but denied payment for J7298 for invalid place of service. Should the IUD be submitted with POS 11 since it was supplied by the practice, not by the facility?

 

[thomas7331]

The patient is in a Comprehensive Inpatient Rehabilitation Center. Insurance paid the provider for the insertion, but denied payment for J7298 for invalid place of service. Should the IUD be submitted with POS 11 since it was supplied by the practice, not by the facility?

Billing for drugs is the responsibility of the facility if it was given to the patient while they were there. Your office should invoice the facility for reimbursement and the facility will include the charge on their claim.

Your provider should probably arrange to have the facility's pharmacy order this drug and have it available to avoid this problem. My guess is it's probably not in compliance with the facility's internal policies for providers bring in drugs from outside as it could pose a liability risk to the facility if there was a problem.