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Wiki medicare botox billing

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pcallanan

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I have recently changed jobs and am working for an outpatient physiatry office. They have begun to give Botox injection. Our outpatient office is in a rehab hospital that is use to charging for the botox thru the facility. I have billed medicare for the outpatient procedure codes 64642 and 64644 etc. and medicare has denied because the facility is billing the exact codes. All commercial insurances are paying while medicare is denying. Can someone tell me if I need a modifier? Medicare states one billing must be backed out to be paid. Thanks for any help in advance
 
Only one entity can bill for the procedure, otherwise it's double billing. Whoever is providing the service should be doing the billing. If two entities are billing for it, then one of them is in the wrong. At least that's my take on this. Possibly I don't understand the situation well enough.
 
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