Neurosurgery Coding Alert

Find out how the number of muscles in the limbs and trunk the physician denervates matters.

You can look for new and specific chemodenervation codes in 2014. All you got to confirm is how many muscles in the trunk or limbs is your surgeon denervating. “The increased use of chemodenervation agents like botulinum toxin have prompted greater granularity in CPT® for describing these treatments,” says Gregory Przybylski, MD, director of neurosurgery, New Jersey Neuroscience Institute, JFK Medical Center, Edison.

Keep a Count on Muscles and Limbs

For chemodenervation of 1-4 muscles in the upper or lower limb, you report code 64642 (Chemodenervation of one extremity; 1-4 muscle[s]). If you read that your surgeon did a denervation for 5 or more muscles in a limb, you report code 64644 (Chemodenervation of one extremity; 5 or more muscle[s]).

For an additional extremity, you report code 64643 (….each additional extremity, 1-4 muscle[s] [List separately in addition to code for primary procedure]) for 1-4 muscles and 64645 (….each additional extremity, 5 or more muscle[s] [List separately in addition to code for primary procedure]).

Be Specific For Chemodenervation of Trunk Muscles

Similar to what you do in the limbs, you keep a count on how many muscles in the trunk your physician denervates. You report 64646 (Chemodenervation of trunk muscle[s]; 1-5 muscle[s]) for chemodenervation of 1-5 muscles and 64647 (….6 or more muscle[s]) for chemodenervation of 6 or more muscles in the trunk.

Note: The count of muscles in the codes for the extremities and trunk is important. The extremity codes 64642 and 64643 are for chemodenervation in initial 4 muscles and the code 64646 is for chemodenervation in initial 5 muscles. You switch to another code after 4 muscles in extremity and after 5 codes in the trunk.