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place of service for cpt code 88300

Sue Posted Mon 28th of March, 2011 20:25:34 PM

Medicare has denied cpt code 88300 with place of service 21 & 22. They state code M77 missing/incomplete/invalid place of service. When we called them they stated that pos 21, 22 & 23 can not be used. unable to find any rule changes!

SuperCoder Answered Tue 29th of March, 2011 18:53:10 PM

The POS designation identifies the location where the laboratory service was provided, except in the case of a Reference Laboratory. A Reference Laboratory must show the place where the sample was taken (if drawn in the Reference Lab, POS 81 is shown; if drawn in a hospital inpatient setting, the appropriate inpatient POS is shown). All entities billing for laboratory services should append identifying modifiers (e.g., 90), when appropriate, in accordance with correct coding. For example, a physician billing for a laboratory service provided by a Reference Laboratory would bill with POS 81 and would append modifier 90 to the code.

Manual and automated laboratory services submitted by a reference or non-reference laboratory provider with a CMS facility POS 21, 22, 23, 26, 34, 51, 52, 56 or 61 will not be reimbursable. These services are reimbursable to the facility. When facilities obtain manual or automated laboratory tests for patients under arrangements with a reference laboratory or pathology group, only the facility may be reimbursed for the services.

Sue Posted Thu 14th of April, 2011 23:14:26 PM

Let me make myself more clear. We are billing for professional component of 88300-26. This is surgical pathology gross only which is proformed by pathologist in a hospital setting. Please advise

SuperCoder Answered Fri 15th of April, 2011 22:47:32 PM

I am getting this information for the first time, and suggesting you to try out: It says,Professional services billed with the following place of service codes will be reimbursed at the FS MAF:

MAA Place of Service Code ------------ Place of Service
--------------------------------------------------------------------
1 -------------------------------- Inpatient Hospital

I don't have very clear idea about this. I hope this can be a clue for you to get more info.

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