Chemodenervation - medial and lateral

barrett

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If injections are made to both medial and lateral gastrocnemius, does this count as injections into 2 or 1 muscle?
 

CodingKing

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Would this fall under 64642 - Chemodenervation of an extremity? That code is for 1-4 muscles.
 

mhstrauss

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Would this fall under 64642 - Chemodenervation of an extremity? That code is for 1-4 muscles.
Yes, but if other muscles are also injected, the 1 vs 2 issue for the gastroc count could make the difference between choosing 64642 vs 64644.

From the research I did when these codes changed last year, the gastroc is 1 muscle. NONE of the coding examples I've seen involving the extremity chemodenervation codes used gastroc in the example, go figure (it's like they purposely avoid giving ANY examples that could help clear up the gray areas!). I haven't been able to find clarification from AMA, AAN, AAPMR, or any other reliable source, so I'm counting it as 1.

HTH some!
 

CodingKing

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Yes, but if other muscles are also injected, the 1 vs 2 issue for the gastroc count could make the difference between choosing 64642 vs 64644.
Thanks for bringing that up. I wasn't even thinking about other muscles not mentioned in the question. Asking about 2 when the lowest code allows 4 should have been my clue.
 

mhstrauss

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Thanks for bringing that up. I wasn't even thinking about other muscles not mentioned in the question. Asking about 2 when the lowest code allows 4 should have been my clue.
No problem! That's just one of those things that, unless you code it often, you won't really be aware of the possible issues with it.
 

barrett

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Thank you so much! This was exactly the issue I was running into. Now, I believe that the quadriceps are 4 separate muscles so I would count them as such, correct?
 
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