New Updates On DOS, POS And TOS

DOS and POS: New rules have been created for DOS and POS if the physician performs only the Professional services (Professional Component). The date of service for the professional component should be the actual date of interpretation and the Place of service should be ’11’ if the interpretation is done in Office or in Physician Home if it meets the definition of Office. In case if physician interprets in Hotel room the POS would be again 11 if the Hotel room is considered as physician Office. If the POS for the professional services doesn’t meet the above criteria then the POS code would be ’99’ (Other). Please refer the below links for more details

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6375.pdf

http://www.cms.hhs.gov/Transmittals/downloads/R1873CP.pdf

The following link gives you the list of all place service codes

http://www.cms.hhs.gov/MedHCPCSGenInfo/Downloads/Place_of_Service.pdf

TOS: Type of service is a single digit Alpha or Numeric indicators required in the field 24C of CMS-1500 form in the past. Various changes have been made to previous existing HCPCS / TOS combinations. The additions and revisions of TOS for the year 2010 can be viewed at

http://www.cms.hhs.gov/Transmittals/Downloads/R1830CP.pdf

Type of Service Indicators

0 Whole Blood
1 Medical Care
2 Surgery
3 Consultation
4 Diagnostic Radiology
5 Diagnostic Laboratory
6 Therapeutic Radiology
7 Anesthesia
8 Assistant at Surgery
9 Other Medical Items or Services
A Used DME
B High Risk Screening Mammography
C Low Risk Screening Mammography
D Ambulance
E Enteral/Parenteral Nutrients/Supplies
F Ambulatory Surgical Center (Facility Usage for Surgical Services)
G Immunosuppressive Drugs
H Hospice
J Diabetic Shoes
K Hearing Items and Services
L ESRD Supplies
M Monthly Capitation Payment for Dialysis
N Kidney Donor
P Lump Sum Purchase of DME, Prosthetics, Orthotics
Q Vision Items or Services
R Rental of DME
S Surgical Dressings or Other Medical Supplies
T Outpatient Mental Health Treatment Limitation
U Occupational Therapy
V Pneumococcal/Flu Vaccine
W Physical Therapy

NOTE: For injection codes with more than one possible TOS designation, use the following guidelines when assigning the TOS:

When the choice is L or 1:

Use TOS L when the drug is used related to ESRD; or

Use TOS 1 when the drug is not related to ESRD and is administered in the office.

When the choice is G or 1:

Use TOS G when the drug is an immunosuppressive drug; or

Use TOS 1 when the drug is used for other than immunosuppression.

When the choice is P or 1:

Use TOS P if the drug is administered through durable medical equipment (DME); or

Use TOS 1 if the drug is administered in the office.