A physician furnishes a Medicare telehealth visit, but charge entry bills place of service 11 (office) as if the patient were seen in person. What claim-data correction is needed?
Select an answer to reveal the explanation.
Short Explanation
Place of service is the claim’s “where did this happen?” label. If the visit was telehealth, POS 11 for a face-to-face office visit is the wrong address on the envelope. Swap in the POS that telehealth rules call for so the claim matches the real setting.
Full Explanation
Place of service is a required professional-claim data element and must align with how and where the service was furnished under payer and Medicare telehealth rules. Reporting POS 11 when the encounter was telehealth misstates the setting and can cause incorrect pricing or denials. Coders should apply the POS required for telehealth for that payer/date of service rather than defaulting to office POS or omitting POS entirely.