Neurology & Pain Management Coding Alert

Question: What is the correct way to report Botulinum toxin injections? Florida Subscriber Answer: For Botulinum toxin injections into facial muscles, use 64612 (Chemodenervation of muscle[s];muscle[s] innervated by facial nerve [e.g., for blepharospasm, hemifacial spasm]). For injections to the cervical spine muscles, use 64613 (... neck muscle[s] [e.g.,for spasmodic torticollis, spasmodic dysphonia]). For extremity or trunk muscles, use 64614 (... extremity[s] and/or trunk muscle[s] [e.g., for dystonia, cerebral palsy, multiple sclerosis]). Per the AMA, chemodenervation coding should be reported with a maximum of one unit of service per day, regardless of the number of injections performed. Note that the Medicare Physician Fee Schedule takes a slightly more liberal approach and allows the chemodenervation injection codes to be reported bilaterally if appropriate. Additionally, some Medicare carriers have addressed reporting chemodenervation injection coding based on one unit of service per -contiguous body part.- It is best to review your payer coverage policies. [...]