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If an independent laboratory bill for a test on a sample drawn on an inpatient or outpatient of a hospital, it uses the code for the inpatient (POS code 21), off-campus-outpatient hospital (POS code 19), or on-campus outpatient hospital (POS code 22), respectively.
Use POS 32 when the patient is in a long-term nursing care facility. Keep in mind that, one facility can provide BOTH types of care. To determine the correct POS for a particular patient, you must know how the nursing facility classifies that patient as SNF or long-term.
Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.
What Is the Medicare Claims Processing Manual? The CMS Claims Processing Manual is part of the Internet-Only Manual (IOM) repository, which provides access to comprehensive information about CMS-administered programming.
For example, physicians/practitioners may use POS code 23 for services furnished to a patient registered in the emergency room, POS 24 for patients registered in an ambulatory surgical center, and POS 56 for patients registered in a psychiatric residential treatment center.
11 Office Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury ...
CR 13314 creates a new place of service code 27 for "Outreach Site/Street" - A non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals.
Recipients who are proven to have abused or misused the Medicaid program may be "locked in" to one doctor and one drug store, be required to repay the Agency for misspent funds and/or may be suspended from the program for at least one year and until full restitution is made.