decisionhealth Newsletters, Coder Pink Sheets - 2013 Issue 2 (February)
Place of service - Report site where patient received face-to-face service, with 2 exceptions
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Article Overview
This article covers Medicare place-of-service (POS) reporting guidance for claims when services are furnished face-to-face, interpreted separately from where they are performed, or delivered in special settings. It is aimed at physicians, billing staff, and revenue cycle teams that need to align claim POS reporting with CMS guidance, MAC processing rules, and hospital status exceptions. The discussion includes CMS policy changes, special site considerations, and references to official CMS guidance documents.
Why This Topic Matters
Accurate POS reporting affects whether Medicare claims are processed correctly and whether payment is made at the appropriate facility or non-facility rate. The article helps billing teams understand the broader reporting framework and the special cases that can affect claim outcomes.
Article Sections
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Medicare POS reporting update
Introduces the CMS update affecting how place of service should be reported on Medicare claims and why providers are being asked to review claim accuracy.
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Exceptions and special cases
Summarizes the article’s discussion of site-specific exceptions, mobile unit considerations, and other special reporting situations addressed by CMS.
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3 points to follow on new POS policy
Outlines practical areas of emphasis for preparing claims under the updated POS guidance, including facility status, diagnostic services, and teleradiology-related reporting.
What You Will Learn
- How the Medicare POS update affects claim reporting
- Which general service settings require special attention
- What categories of services and locations are discussed in the CMS guidance
- How official CMS resources are referenced in the article
Who Should Read This
- Physician practices
- Medical coders
- Billing staff
- Revenue cycle teams
- Compliance staff
Codes Discussed
Code Ranges Discussed
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