Place of Service Override

Override the place of service (POS) code on claims. Optionally filter by CPT codes and original POS value.

Applies to: Professional (837P), Dental (837D)

When to Use This

Telehealth claims need POS changed from 11 (Office) to 02 (Telehealth) or 10 (Telehealth in Patient Home)
A payer requires a specific POS for certain procedure codes
Your source system sends the wrong POS and you need to correct it before submission

Field	Required	Description
Start Date	Yes	When this rule becomes active
End Date	No	When this rule expires
Payer Number	No	Only apply for a specific payer. Blank = all payers
CPT Codes	No	Comma-separated CPT codes. Only override POS on claims with these codes. Blank = all claims
Original Place of Service	No	Only override if the current POS matches this value. Blank = override regardless of current POS
New Place of Service	Yes	The new 2-digit POS code to set
Notes	No	Your reference notes

Code	Description
02	Telehealth Provided Other than in Patient's Home
10	Telehealth Provided in Patient's Home
11	Office
12	Home
21	Inpatient Hospital
22	On Campus - Outpatient Hospital
23	Emergency Room - Hospital
31	Skilled Nursing Facility
81	Independent Laboratory

All telehealth E/M codes for Aetna should be POS 02 instead of 11.

A payer requires POS 11 on all claims regardless of what's sent.

Field	Value
Payer Number	00621
New Place of Service	11

Reads the current POS from the CLM segment (element 5, sub-element 1) in Loop 2300
If Original Place of Service is set, only changes it if the current value matches
Sets the new POS value
A note is added documenting the change
Shows in Applied Validation Modules as “PlaceOfServiceOverrideModule”