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Place of Service Codes
Apr 9th, 2009 by Anna

Place of Service Codes

April 9, 2009

When billing E/M CPT codes and other CPT codes, the place of service (POS) code must be accurate in order to ensure quick and accurate reimbursement. A claim may be denied if the POS code is incorrect.

Place of Service Codes

04 – Homeless Shelter 26 – Military Treatment Facility
05 – Indian Service Free Standing Facility 31 – Skilled Nursing Facility (SNF)
11 – Office 32 – Nursing Facility
12 – Home 33 – Custodial Care
13 – Assisted Living 34 – Hospice
14 – Group Home 54 – Intermediate Care Facility (ICF)
20 – Urgent Care Facility 55 – Residential Substance Abuse Treatment Facility
21 – Inpatient Hospital 56 – Psychiatric Residential Treatment Center
22 – Outpatient Hospital 61 – Comprehensive Outpatient Rehab Facility
23 – Emergency Room – Hospital 62 – Comprehensive Outpatient Rehab Facility
24 – Ambulatory Surgical Center 72 – Rural Health Clinic
25 – Birthing Center 99 – Other Place of Service Not Listed

Certain E/M CPT codes can only be used in certain locations and it is important that the POS codes match the billed CPT codes. Below are descriptions of the most common POS codes Thousand Cranes clients use.

POS 11 - Office

Office: Any location, other than a hospital, SNF, military treatment facility, community health center, state or local public clinic or ICF, where the health professional routinely provides health examinations, diagnoses, or treatment of illness or injury on an ambulatory basis.

CPT Codes: Office or Outpatient codes 99201 – 99215, 99354 – 99355, and Office or Other Outpatient Consultations 99241 – 99245.

POS 12 – Home

Home: A location other than a hospital or other facility, where the patient receives care in a private residence.

Use POS 12 to report E/M services provided in a private residence of the patient. Surgical procedures can be billed as well. May be used for all DMEPOS services. Do not use POS 12 for assisted living (POS 13) or POS 14 (group home) codes.

CPT Codes: New patient home service codes 99341 – 99345, Established patient codes 99347 – 99350.

POS 20 – Urgent Care Facility

Urgent Care Facility: A location, distinct from a hospital emergency room,an office or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention.

CPT Codes: E/M codes 99201 – 99215, Consult 99241 – 99245, surgical codes

POS 21 – Inpatient Hospital

Inpatient Hospital: A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and non-surgical), and rehabilitation services, by or under, the supervision of physicians to patients admitted for a variety of medical conditions.

CPT Codes: Observation 99217 – 99220, Inpatient 99221 – 99233, Same day observation 99234 – 99239, Consult 99251 – 99255, Prolonged service 99356 – 99358.

POS 22 – Outpatient Hospital

Outpatient Hospital: A portion of a hospital which provides diagnostic, therapeutic (both surgical and non-surgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization.

CPT Codes: Office or Outpatient Service Codes 99201 – 99215, 99354 – 99355, Office or Other Outpatient Consultations 99241 – 99245

CPT codes, descriptors and other data are copyright 2009 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.

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