Neurology & Pain Management Coding Alert

Question: Can we bill chemodenervation codes 64612-64614 bilaterally? If so, which modifiers should we report for bilateral Botox injections?Maine SubscriberAnswer: Whether you can code for bilateral Botox administration depends on what sites your physician injects. For example, you can bill bilateral injections for facial muscles and extremities, but you cannot report separate injections to each side of the neck muscle.The physician fee schedule is a good place to start when  ou're dealing with bilateral billing dilemmas. You'll find a "1" indicator in the bilateral surgery column for 64612 (Chemodenervation of muscle[s]; muscle[s] innervated by facial nerve [e.g., for belpharospasm, hemifacial spams]) and 64614 (... extremity[s] and/or trunk muscle[s] [e.g., for dystonia, cerebral palsy, multiple sclerosis]). This means that you can append modifier 50 (Bilateral procedure) to the procedure code and recoup 150 percent of the fee when your provider administers bilateral injections.No go with zero: If you find a status indicator [...]