Forum - Questions & Answers
We billed 99495 with POS 11 and Medicare denied the claim as invalid POS, chkd with the docs and found patient was at inpatient stay for the Dos, so refiled the claim with POS 21. Again receiving the pos denial as co58. please assist me, which pos can i bill ?
The place of service reported on the claim should correspond to
the place of service of the required face-to-face visit.
You will need to use inpatient codes to go with inpatient place of service. (POS).
Are you using the correct date of service?
The TCM's DOS is the 30th day from the date of discharge because this code is for the evaluation and management of the patient's care for the next 30 days after discharge. Even though the face to face visit was a few days after the discharge. Contact from the patient has to be initiated within the first 2 days of discharge AND the face to face visit is within the 14 calendar days of the discharge. Bill the TCM CPT® code based on the days seen from discharge. Our TCMs are done in office so will be POS 11. Your DOS for the TCM has to correspond with the 30th calendar day from the date of discharge.