Anesthesia Coding Alert

Botox, Dysport, and Myobloc all carry FDA approval for treatment of cervical dystonia (333.83, Spasmodic torticollis) -- but that doesn't mean you code each case the same.

Example: A patient with refractory cervical dystonia comes to your office and your physician injects botulinum toxin for therapeutic purposes. Remember that the potency units of the three botulinum toxins are not interchangeable, says Marvel Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, owner of MJH Consulting in Denver.

Alter your coding for each scenario as follows:

• Your provider injects a total of 200 units of Botox (onabotulinumtoxinA) -- Report J0585 with 200 billing units because the code descriptor is "per unit." Calculation: 200 units injected/1 unit in code descriptor = 200 billing units.

• Your provider injects a total of 500 units of Dysport (anabotulinumtoxinA) -- Report J0586 with 100 billing units because the code descriptor is "per 5 units." Calculation: 500 units injected/5 units in code descriptor = 100 billing units.

• Your provider injects a total of 2,500 units of Myobloc (rimabotulinumtoxinB) -- Report J0587 with 25 billing units because the code descriptor is "per 100 units." Calculation: 2,500 units injected/100 units in code descriptor = 25 billing units.