In these cases, the correct POS code — regardless of where the face-to-face service occurs — is that of the appropriate inpatient POS code (at a minimum POS code 21) or that of the appropriate outpatient hospital POS code (at a minimum POS code 22) as discussed in section 10.5 of this chapter. So, if in the above example, the patient seen in the physician’s office is actually an inpatient of the hospital, POS code 21, for inpatient hospital, is correct. In this example, the POS code reflects a different setting than the address and ZIP code of the practice location (the physician’s office). When a physician/practitioner/supplier provides services to a patient who is an inpatient of a hospital, the inpatient hospital POS code 21 will be used irrespective of the setting where the patient actually receives the face-to-face encounter. ED with a delivery of baby I have a billing issue where the billing dept is arguing that if the patient doesn't go home the ED code 99282-84 uses POS 22. Then the delivery is POS 21. I am arguing if the dr write the order and they are in labor they are classified as In pt even if they go up to the labor floor or stay in the ED dept. The place of service is always the place where the test was performed, in this case, POS 21. CMS made that rule, and sometimes we have to point these rules out to the contractors to get them paid. But my post came directly from CMS, so that's what I'd recommend you use for Medicare recipients anyway. Commercial payers have other rules, but they may vary by state, so you often have to. Can two different POS codes be billed on same CMS1500 form? Two different dates of service. ex. Line 1 DOS POS 21; Line 2 DOS POS 11. There are two exceptions to the rule: 1. When a physician/practitioner/supplier provides services to a patient who is an inpatient of a hospital, the inpatient hospital POS code 21 will be used regardless of the setting where the patient actually receives the face-to-face encounter. 2. 21=A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions. 61=A facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. 1. Services rendered to a patient who is a registered inpatient should be reported with POS code 21 (or other appropriate inpatient code), regardless of where the services were provided. If you know the exact setting in which the patient is a registered inpatient, you may report another appropriate inpatient POS code (rather than POS 21). MCR is denying the 99213-99215 or 99203-99205 but paying the 99406 when billed on the same DOS. We are only linking F17.210 to 99406, while our other dx are linked to the 99203-99205 / 99213 - 99205 code. We are ensuring the provider documents all necessary elements in order to bill the 99406.