Botox for Migraines

[amandakay692]

Surgeon is going to start doing therapeutic Botox injections for migraines. The injections will be 150 units in the neck. I have come up with J0585x150 and 64615 but cannot figure out the right DX code so BCBS will not reject the claim for not medically necessary.

 

[SharonCollachi]

Your local Blue should have a coverage document.

 

[jkyles]

Surgeon is going to start doing therapeutic Botox injections for migraines. The injections will be 150 units in the neck. I have come up with J0585x150 and 64615 but cannot figure out the right DX code so BCBS will not reject the claim for not medically necessary.

Hi there, you should recheck the procedure code. The code for the migraine injection involves more than the neck. And as stated above, you'll need to check each payer's policy for the covered diagnosis codes. Some can be quite strict so be prepared for instances when it isn't covered.

diagnosis codes, diagnosis coding

 

[Pam Warren]

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56472&ver=13

Anthem (and other commercial policies) will be similar.

diagnosis codes, diagnosis coding