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Place of Service - (11) for Independent lab and hospital based pathology group

Chrys Posted Thu 18th of February, 2016 10:30:04 AM

I am looking for guidelines for when to use POS 11 for an Independent Lab and hopsital based pathology group. For the Hospital based group - do we use where the specimen was obtained versus where the pathologists read and diagnosed the case? For an Independent Lab with an (81) do we use 81 or 11 when the specimen is obtained at a surgeon's office and sent to lab to read and diagnosis?

SuperCoder Answered Fri 19th of February, 2016 15:27:28 PM

As per the guidelines, the majority conventional wisdom historically and today is that the place of service code for pathology and laboratory services should reflect the type of facility that was being visited by the patient when the specimen was extracted.
For example, if a biopsy is taken during the physician office visit, the pathologist or independent laboratory should report POS 11 (office or clinic) on the claim for processing and examining the biopsy even if the professional and/or technical component is performed at an independent laboratory. Thank you.

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