Respuesta :
POS code 11 (office) or POS code 22 (outpatient hospital) claims adjustment reason code will result if this code is billed 99201, POS 12.
What is claim adjustment?
The procedure of assessing coverage, legal culpability, and settling a claim is known as claims adjusting. To keep the commitments made by the insurance to its policyholders, the claim function was created. Establishing an insurer's relationship with its policyholders requires effective claim adjusting.
The Medicare electronic and paper remittance advice as well as the Coordination of Benefits (COB) claim transaction use Claim Adjustment Reason Codes (CARCs). This code set is kept up to date by the Claim Adjustment Status and Reason Code Maintenance Committee.
There is an expectation that a doctor will be paid for the services they render when they treat a patient. The provider is not paid when the payer issues a refusal and requests a claim adjustment. Depending on the rationale for the denial, these refusals are frequently subject to appeal.
To know more about the claim refer to: https://brainly.com/question/13510091
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