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Neurology & Pain Management Coding Alert

Reader Questions:

Choose the Right Botulinum Injection Code

Published on Fri Oct 22, 2010

Question: The neurologist that I work for has started to perform injections of Botulinum toxin. Is 64640 the correct code to report these chemodenervation injections? Washington Subscriber Answer: Some coders incorrectly look to 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) as the code to report chemodenervation injections. However, chemodenervation is not a destructive procedure. The toxin creates a "block" at the injection site(s) of the communication between the nerves and contracted muscles. You should look to one of the specific chemodenervation CPT codes to report these injections. Get specific: Report the following codes based on the documented anatomic site: - 64612 (Chemodenervation of muscle[s]; muscle[s] innervated by facial nerve [eg, for blepharospasm, hemifacial spasm]) for facial injections - 64613 (- neck muscle[s][eg, for spasmodic torticollis, spasmodic dysphonia]) for neck injections - 64614 (... extremity[s] and/or trunk muscle[s] [eg, for dystonia, cerebral palsy, multiple sclerosis]) for extremity/trunk injections. [...]
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