Wiki Cryo Surgery in a nursing home

sdennis

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Klamath Falls, OR
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One of my providers saw a patient at a nursing home and while there did a cryo on a basal cell carcinoma.

I coded the E&M for the nursing home visit and coded the cryo as a seperate service. Medicare has denied the cryo stating the procedure code and place of service don't match up.

Does anyone have any helpful hints? Would the cryo be bundled with the E&M because of the place of service. The basal cell carcinoma was not the only reason for the visit.

Knowing this provider, I will need to be able to show something in writing explaining why I can't get the seperate procedure paid, if that is the case. So, if that is the case does anyone know where in the medicare manuals I would find this rule. I have been looking but the amount of information is daunting.

Thanks
Sara, CPC
 
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