Our provider gave Botox 155mg and 45mg JW for waste due to pain in cervical region. Medicare denied due to another ENT provider also billing Botox on same dos in the throat. Our claim is being denied because the ENT already billed the botox on the same dos and was paid. The ENT is a totally separate clinic and specialty, we didn’t know patient even saw that provider. Noridian is saying we need a modifier to bypass but I cannot think of an appropriate modifier in this situation. Do we just appeal the denial without a modifier?