Wiki botox injection if a provider administers

[sisemrgncy]

if a provider administers botox injections to a patient for spasmodic torticollis i am being told we can not bill the E&M or the admin codes only the J0585 and 64613, 64614.

 

[docndent]

I would think if you modified the E/M code with a -25 you could bill it with the CPTs and the J code.

 

[ollielooya]

It depends....was the patient scheduled for this particular service? If a separately distinguishable service was provided in ADDITION to this service, then the EM service w/mod. 25 could be utlized. I'm still so much of a rookie, but this is how I understand it. Our office does these type of procedures on a daily basis. In other words, if the patient was seen a few days prior and doctor provided an E/M service and told the patent to come back for the botox injections, then no, it is my understanding adding the EM/25 would not be justifiable. I hope others will join in and comment. And remember the administration of the neurotoxin to paralyze the dysfunctional muscle tissue is included in the choice of the 64612, and 64613 according to the Coder's Desk Reference of 2010.
---Suzanne E. Byrum, CPC

 

[Speltzman]

Botox/Medicare

I agree with the last post on coding a E&M. We bill J0585 and 64613. Recently been having troubles with Medicare denying as not medically necessary to do a LCD policy. Anyone here dealing with Kansas Medicare?

 

[companey]

My Doctor does botox injections on every thursday. We bill for the Injection and for the botox itself. We have patient come in every 90days for their injection and that is why they are coming in so E&M code wont work.