Place of service affects your reimbursement

By Mary LeGrand, RN, MA, CCS-P, CPC

Facility, nonfacility designations make a difference

In 2008, the Office of Inspector General (OIG) for the department of Health and Human Services intends to focus on Place of Service errors for services submitted by physicians. According to the OIG work plan, “We will review physician coding of place of service on claims for services performed in ambulatory surgical centers (ASC) and hospital outpatient departments. Federal regulations… provide for different levels of payments to physicians depending on where the services are performed. Medicare pays a physician a higher amount when a service is performed in a non-facility setting, such as a physician’s office, than it does when the service is performed in a hospital outpatient department or, with certain exceptions, in an ASC. We will determine whether physicians properly coded the places of service on claims for services provided in ASCs and hospital outpatient departments.”

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