LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone: 305.436.5030
Fax: 305.436.0086
E-mail Address: info {at] LEEDerGroup [dot] com

2012-12 New Place of Service (POS) Code for Place of Employment-Worksite

Jurisdiction 11 Part B

New Place of Service (POS) Code for Place of Employment/Worksite

MLN Matters® Number: MM8125 Related Change Request (CR) #: CR 8125 Related CR Release Date: November 30, 2012 Effective Date: April 1, 2013 Related CR Transmittal #: R2602CP Implementation Date: April 1, 2013

  • Provider Types Affected
    This MLN Matters® article is intended for physicians, other providers and suppliers submitting claims to Medicare Contractors (Medicare Carriers, Medicare Administrative Contractors (A/B MACs) or Durable Medical Equipment Medicare Administrative Contractors (DME MACs)) for occupational-related medical, therapeutic or rehabilitative services provided to Medicare beneficiaries.
  • What You Need to Know
    Change Request (CR) 8125, from which this article is taken, updates the current Place of Service (POS) code set to add a new code: 18 – Place of Employment/Worksite.
  • Background
    CR 8125, from which this article is taken, updates the current Medicare POS code set to add a new code: 18 – Place of Employment/Worksite, described as: ‘a location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic, or rehabilitative services to the individual.’
    The Centers for Medicare & Medicaid Services (CMS) is establishing this POS code because:
    Industry entities (other than Medicare) have identified a need to establish the delivery of occupational-related medical and rehabilitation services in the work place in order to: a) reduce employee time lost from work; and b) enable therapists to evaluate the work environment and provide rehabilitation services that are focused on returning the individual to their pre-injury state in a way that maximizes function in the workplace environment and reduces employee time lost
    As a Health Insurance Portability and Accountability Act of 1996 (HIPAA) covered entity, Medicare must comply with its standards and their implementation guides that are adopted by regulation. Specifically, the currently adopted professional implementation guide for the Accredited Standards Committee (ASC) X12 837 (Professional Health Care Claim) standards requires that each electronic claim transaction include a Place of Service (POS) code from the POS code set that CMS maintains.
    Therefore, while it has not identified an inherent need for this new code, as a payer, Medicare must be able to recognize any code from the POS code set that appears on the HIPAA standard claim transaction.

This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2011 American Medical Association.

last updated on 12/04/2012