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Wiki Appealing MCR denial for POS?

meguzma86

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Our Nephrologist performed a 36589 (CV Cath Removal) on a pt in an outpatient dialysis center (POS = 65). MCR dnd for invalid POS for procedure. I appealed with notes showing place of service, the date of the removal, and notes from our specialist. I appealed a MCR claim for POS that came back unfavorable stating, "Medicare will not pay for the 36589 when billed with the place of service 65. Please verify the procedure performed and the place of service being billed." I don't know what else I can do to try to get this paid as I sent in all the evidence that we performed this procedure at this center. Any suggestions or is just a lost cause??
 
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