Wiki Billing Medicare for NP services in an outpatient rehab hospital

jwest10782

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I have run into a situation with a NP doing Botox injections for spasticity in POS 22. First, am I right in thinking that it is not appropriate to bill Medicare incident to in POS 22 even if there is a supervising physician?

Right now we are billing using just the NP NPI and CPT code 64642 is getting paid. However, additional add on codes such as 64643 and 64644 are not being paid. Are there certain codes that Medicare will not pay when an NP is rendering the service and billing Medicare directly? We are also billing 95874-26 as the NP is using EMG needle guidance for the procedure and we are receiving denial CO-58 Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Any help is much appreciated!
 
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