A neurologist has been made to repay $1.5 million for inappropriate billing of MBS items for nerve conduction studies and Botox injections.

In its latest outcomes statement, the Medicare claims compliance watchdog, the Professional Services Review (PSR) said the un-named neurologist had also received a reprimand and been disqualified from providing the MBS items for a year.

In its report, the PSR said its surveillance of neurologists’ billing practices had identified one practitioner who was a high biller of MBS item 11021 (neuromuscular diagnosis), item  11027 (investigation of CNS evoked responses) and 18362 (Botox injection for severe primary axillary hyperhidrosis).

The PSR also identified numerous problems with the practitioner’s rendering of MBS items 116, 132, 133, 834, 880, 11018, 11021, 11027, 11300, 11713 and 18362.

Its review found that the neurologist had failed to meet MBS requirements for the items, including minimum time requirements for professional attendance items.

In some cases not all services billed were clinically indicated. Also, the neurologist’s clinical input was not always adequate.

“For example, some MBS item 18362 (Botox injection) services were rendered on the practitioner’s behalf by another medical practitioner,” the PSR said.

In other instances, the practice records were often inadequate and in particular, some investigations did not have corresponding reports.

“The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items of concern,” the PSR noted.

The neurologist agreed to repay $1,500,000, to be disqualified from providing MBS items 132, 834, 11018, 11021, 11027 and 11713 for 12 months, and will be reprimanded by the PSR Director.