Place-of-service coding counts when billing for services
One of the key topics listed in the 2007 Work Plan just published by the Office of Inspector General (OIG) is billing with the correct place-of-service code. Reimbursement is typically based on place of service, and Medicare and other third-party payers consider several factors (e.g., the overhead costs of the facility or office) when reimbursing a provider for professional services. Billing with the correct place-of-service code is critical. If the visit code is not mapped to the correct place-of-service code (in other words, if the service actually took place in a different location), the provider's documentation will not match the billing and the claim could be deemed fraudulent/rejected.
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