Questions for Dr. Stern
About Your Urgent Care Center
62. We bill for 4 clinics that are licensed as "outpatient clinic". We are confused on the place of service code because the 22 states the facility is part of the hospital and the urgent care seems more appropriate but we were told it was not appropriate because it must be a provider based and doctor owned facility that doesn't bill separately for the facility charge. We only bill the professional charge for our doctors. Any help or guidance you can give me would be much appreciated.
No matter what your location (hospital, free-standing, in multispecialty clinic, etc.) or billing structure (facility only, provider only, combination) every payor is likely to see this issue differently. There is no hard-and-fast rule for any given payor. If you are not verify what the payor wants, I personal opinion is that in your situation you may minimize denials by using the place of service -22 (Outpatient Hospital,), but it always best to check with the payor. Of course, most of us hate that “check with your payor” phrase because so often the payor representative does not know the answer or, even worse, gives us the wrong answer.
Hope that helps. Take care and feel free to drop us a note with any future coding questions.
