NCV/EMG 95913 95886 denial with medicare

[impulseje]

Hi.We are we group that billing ncv/emg.95913,95886,we have PM&R in our group.We billing medicare but getting denials,the reason is that this type of provider cant bill.we did all required paperwork with medicare,his info on our group in medicare.He is also billing under his clinic and he getting paid from medicare,what can be the problem?
 
Thank you in advance.

[Michele]

Have you tried calling Medicare to ask them to clarify the denial?  There is really not enough info for us to tell you for sure what the problem is.  If it were me I would call Medicare to ask them to explain why the provider isn't eligible to bill the codes being denied.

[impulseje]

I called them,they told me that this type of provider not allowing to bill these codes,but what strange that this doc PMR,he have his own clinic and he getting paid,so i thinking may be im doing something wrong in billing?im putting him rendering provider

[impulseje]

Was checking the settings in my software(pc ace 32) and found out that cms specialty code was 72 which is pain managment,and we need 25 physical medicine and rehab,put it 25 and rebilled right now,can it be the possible problem?

[Michele]

It may be.  I would try that and see what happens.  Otherwise I would get an example (minus the PHI) of where they paid to see how that was billed.

[impulseje]

Yes,i took medicare eob and billed exactly like on eob that was paid.Probably it was my mistake in specialty,for rendering i was suppose to put 25(this is our doc that on our medicare number) and for us 70(multi specialty clinic).is taxonomy matter ? i billed one with 208100000X its doc taxonomy i putted for us and one with 19200000X for multi specialty.If we doing ncv under supervision of PMR ,do we need to put taxonomy multi specialty or doc's taxonomy for us?

Thx.