An item of interest in the 2015 Office of Inspector General (OIG) Work Plan is the place of service (POS) reported for services provided in ambulatory surgery centers and outpatient departments of hospitals. (See the related e-article, “2015 Office of Inspector General Work Plan: Why Should This Interest You?” at http://coding.aap.org.) While POS codes are often applied to claims automatically based on configuration of sites of service within the practice management system, accuracy of POS codes should not be taken for granted. Here’s why.

Most payers base payment for physician services to some degree on the Medicare Physician Fee Schedule (PFS) published each year by the Centers for Medicare & Medicaid Services. The PFS includes differential payment for certain services based on site of service, facility or non-facility. This is intended to appropriately account for the practice expense that applies when a physician provides care in a non-facility setting...

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