Need help with thoracic dermatome Dysport injections

mhstrauss

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Hi, hoping to get some help with this procedure that I've never come across. I've searched around, and am not finding anything to support/negate the code he's wanting to use, or any others. At this point, leaning towards agreeing with 64640.

Doctor's question: can you please verify that I placed the order correctly for this toxin injection procedure (**he charged 64640)? Gave injection to left thorax using sampled Dysport. I injected subdermally so I didnt think I would charge for thoracic muscles.

Procedure note:

Patient is a 70-year-old female with history of post herpetic neuralgia that has failed previous treatment trials with gabapentin, Lyrica, and lidocaine cream. Her pain is severe and constant and present for the past 5 months. Today we will initiate a treatment trial using botulinum toxin (Dysport) further therapeutic treatment of her postherpetic neuralgia occuring along the left T10 dermatome.

Sample dose of Dysport 500 units was used for this procedure. 500units of toxin was mixed into 5cc of NS to create 100units/mL. 10 units of toxin were injected subdermally every 2cm until a grid of equally spaced injections cover the symptommatic area of the posterior left T10 dermatome. A total of 40 injections/400units was injected subdermally into the target region, and the remaining 100units of toxin was discarded.

There was no complications from the procedure. Patient was instructed to notify MD of any side-effects such as dyspnea or skin reaction occur.



I appreciate any help anyone can give!!
 
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