Gaining Clarity with Place of Service Codes for Insurance Claims
If you are in private practice you probably have no need to be concerned with “Place of Service” codes if you never leave the office.
However, those of you who are visiting premises other than your consultation practice should be aware of the importance of the different service codes insurance companies need.
You are more than likely using the default billing code 11 for your home office. When you visit a client, however, you should be using a different code. But, which one?
Gaining Clarity with Place of Service Codes
Understanding which Place of Service Code to Use
There is no uniformity when it comes to using these codes. In fact, in some instances, one might feel that the insurance companies themselves are confused.
They all have their own code for out of office consultations. You may also be required to provide additional credentialing along with the code.
For example, sometimes code 12 is required for home therapy with additional credentials. Others, a code 13 for assisted living patients. Nursing facilities may require another code, and this may vary depending upon whether there are skilled nursing facilities.
Then there were those insurance companies who had no procedure for therapists practicing outside the office.
Gaining Clarity Insurance Claims with with Place of Service Codes
Why is Recording the Right Code Important?
While the insurance companies might be of very little assistance, the onus falls to you to ensure you are using the right code. If not, you may be liable and find yourself in trouble.
If you have been emailing insurance companies it is important that you save them for future reference. Then you’ll have created a ‘paper trail’ which you can use to support your claim.
You might consider automating the process of getting reference numbers or saving emails for all correspondence with insurance companies just in case.
Your staff need to be update with which codes they should be registering. A list of codes can be found here - Medicare
Let Therasoft help your clinic develop clear documentation practices.
