tci Medicare Compliance & Reimbursement - 2013 Issue 9

Reader Question: Don't Change Inpatient POS for Radiology

Question:One of my coworkers heard that some Medicare rules have changed regarding whether face-to-face time can change a patient’s inpatient/outpatient status when a radiologist is involved. What is she talking about? Answer: Your coworker probably is referring to the situation when determining the proper place of service to list on the claim. This can sometimes be tricky when you’re billing radiology’s interpretation and report. The good news is that new CMS guidance will set you straight. The latest Medicare rule states that the POS code you put on the claim needs to reflect the "setting in...

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