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Place of Service Code Hierarchy

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This topic details information on how place of service code is linked to claims. The basic rules are as follows for determining why a particular place of service code is output for a claim.

Resolution

  1. If the Place of Service Override is populated on the rate link screen for the program/service under Finance Setup>Payer/Contract Setup>Payers>Plans/Contracts Rates) then this is what will output for the claim.
  2. Actual Location entered on Service Entry form (the actual location must be linked to place of service for the claim output under Finance Setup>General Setup>Claim Output>Place of Service Codes)
  3. Default Location entered on the Services Setup by Program (the actual location must be linked to place of service for the claim output under Finance Setup>General Setup>Claim Output>Place of Service Codes)
  4. Default Place of Service entered on Receiver

 

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