- April 4, 2022
- Posted by: Josh Knoll
- Category: Urgent Care Billing
An Introduction to Medical Codes
The medical billing system, as defined within the US healthcare sector, is distinctive in its use of an elaborate coding system. Every claim that is submitted to an Insurance provider needs to be accompanied by a number of codes. These codes refer to various aspects that constitute the claim for reimbursement, signifying such facets as the diagnosis to the treatment. There is also a code that signifies the place where the treatment was provided. This is known as the Place of Service or POS code.
Choosing the correct POS code is as important as every other code used during billing for ensuring that the claim is accepted and reimbursed, and not rejected. It often happens that an otherwise perfect-looking claim gets rejected just because it carried the wrong Place of Service code. So, when it comes to Urgent Care billing, what is the correct code to use?
Codes Used in Urgent Care Billing
The answer is, POS-20. This is the code that can be used if the place of service is an Urgent Care facility. POS-20 came into effect from January 1, 2003 and is meant to be used exclusively for Urgent Care centers. It is important to understand in this context that such a center should be distinct from an emergency room in a hospital, office or clinic and its purpose should be to treat and diagnose injury or illness for any unscheduled patient who visits it seeking medical attention.
One should be careful not to confuse it with the POS-17 code which is reserved for walk-in retail health clinics. Even though such clinics provide primary care services on an ambulatory basis, they are quite distinct from Urgent Care facilities, a physician’s office or a pharmacy. It is important to remember that the POS-17 code should be used in cases where the place of service is not described by any other POS code. One may also use the POS-99 code when a place of service is not identified by another POS code.
Ensuring Better Coding Accuracy
Such intricacies of Urgent Care billing necessitate a highly disciplined approach to the whole matter. Even the slightest mistake can result in rejection and a loss of precious time & effort. Without adequate knowledge of the latest codes or the various claim filing requirements as demanded by different payors, billing efforts can quickly turn into a nightmare.
This is why a growing number of Urgent Care facilities across the US are outsourcing their billing to professional, third-party billing experts. Not only does it reduce denials and increase collections, but it also lowers operational costs in a significant way. On the whole, appointing a dedicated billing partner can have a beneficial effect on the overall profitability of an Urgent Care facility.