Neurology & Pain Management Coding Alert

Question: My neurologist scheduled two patients back-to-back for botulinum type B injections. But he didn't use all of the Botox and we disposed of it. Do I need to report the wastage when my neurologist doesn't use the entire amount of botulinum toxin? If so, how do I report the wastage? Nevada Subscriber Answer: Yes, you can typically bill for botulinum toxin waste. If you split the vials between patients, bill for the exact units given per patient. If your provider has some leftover, bill for the total number of units used. Then you document the number of units that had to be wasted or discarded on the final patient. In your example, you might report 64613 (Chemodenervation of muscle[s]; neck muscle[s] [e.g., for spasmodic torticollis, spasmodic dysphonia]) for one procedure, and report 64614 (... extremity[s] and/or trunk muscle[s] [e.g., for dystonia, cerebral palsy, multiple sclerosis]) for the other. Say [...]