All place of service codes permissible under HIPAA will be accepted on the 837 Professional Claim File, but only two of the codes will effect the adjudication of the claim in MACSIS. View the complete list of codes.
The two codes, which will affect MACSIS adjudication, include "51 - Inpatient Psychiatric Facility" and "09 - Prison-Correctional Facility." Code "51" should be used to report clients treated in an Institution for Mental Disease (IMD) as defined in 42CFR 435.1009. Code "09" should be used to report clients treated while in the penal system. Until 7/1/2007 Place of Service Code "99 - Other Unlisted Facility" may also be used to report clients in the penal system.
For more information regarding the use of place of service codes and the effect on MACSIS adjudication, refer to the Guidelines Pertaining to MACSIS, HIPAA EDI Policies and Procedures, Section 44D3.