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Questions for Dr. Stern

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30. I was interested in more information on the "S" Codes. I do have a question though concerning the following: How does clinic licensing/certification effect the reimbursement for the facility? eg. OV versus Urgent Care*Place of service 11- OV , 20-UC ********  is affiliated with a local hospital as a free-standing UC/WC Clinic. The practice is comprised of Industrial Medicine Visits (injuries/preplacement) and Walk-in Urgent Care Visits based upon after hours contracts with medical groups, IPAs, and insurance carriers.

Good question. It is generally best to use POS-20 (when appropriate) if billing an S9083 or S9088. However, it will depend on what your payor requires. Some payors will pay on either POS and some will pay on neither. You can call and ask; good luck finding anyone with the correct answer. Or you can send in a few trial claims for each payor and record your results.
Note: Make sure that you are seeing patients for walk-in, unscheduled visits if you are using these codes. Let me know if this answers your question.

 

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David Stern, MD, CPC
CEO, Practice Velocity
Partner, Physicians Immediate Care
Board Member, Urgent Care      Association of America

Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

 

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