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January 25, 2018

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Medical Coding News Archives

New Place of Service Code Effective April 1

March 29, 2013:

Beth Ford, RHIT, CCS, Clinical/Technical Editor

Effective April 1, 2013, Change Request (CR) 8125 is adding a new code to the current place of service (POS) code set: 18 Place of employment/worksite. This code defines “a location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides ongoing or episodic occupational medical, therapeutic, or rehabilitative services to the individual.”

This policy applies to services paid under the Medicare physician fee schedule and requires physicians and other suppliers to report the POS code as the setting where the Medicare beneficiary receives the face-to-face service. Two exceptions are made for inpatient (POS code 21) and outpatient hospital services.

Both the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Accredited Standards Committee (ASC) X12 837 (Professional Health Care Claim) standards require that each electronic claim transaction include a code from the POS code set, maintained by the Centers for Medicare and Medicaid Services (CMS). Medicare, as a payer, must be able to recognize any code from the POS code set according to HIPAA standard claims transactions, including those for occupational (non-Medicare) claims.

CMS recognizes an industrywide need to identify occupational-related services. POS code 18 will help reduce time lost from work and enable physicians and therapists to provide rehabilitation services designed to restore pre-injury or illness health status.


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