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Botox billing advice needed!

  1. #1
    Default Botox billing advice needed!
    Medical Coding Books
    Hello!
    I work for a family physician who is interested in doing cosmetic Botox injections. I know to use code J0585 for the Botox, but what code should be used for the administration? 90772? 90471 (since it's technically a toxin)?
    Any advice would be appreciated
    Carrie, BS, CPC

  2. #2
    Default Botox
    Are you also going to be billing the chemodenervation codes? If so, the administration of the botox is included in the procedure code.

    Becky
    Becky Zellmer, CPC, MBS, CBCS
    Medical Billing and Coding Supervisor
    SVA Healthcare Services, LLC
    zellmerb@sva.com

  3. #3
    Location
    Stratford, NJ
    Posts
    39
    Default cosmetic botox
    Hi cdcpc,
    I don't believe you should use either. 90471 is strictly for immunizations. 90772 is used for therapeutic, prophylactic, or diagnostic, which are not the cases either. I think you would use 11950 - 11954. These are just introduction codes. If you're only doing it for cosmetic, you wouldn't be doing any chemodenervations, diagnosing, or any kind of therapies. I'm no expert, but I would use them., Hope this helps.
    Liza

  4. #4
    Default
    Quote Originally Posted by beckyz View Post
    Are you also going to be billing the chemodenervation codes? If so, the administration of the botox is included in the procedure code.

    Becky
    Becky,
    No--we wouldn't be doing chemodenervation codes. This is a strictly cosmetic procedure.
    Thank you!
    Carrie, BS, CPC

  5. Default Cosmetic Botox
    We use 64612 for injection of botox into the forehead.

    Tina

  6. #6
    Location
    Albany, New York
    Posts
    457
    Default
    O.K., maybe I'm missing something here..........
    If these are strictly "cosmetic", why are they being coded?

    If there is an insurance carrier out there who pays for this, please let me know!
    Karen Maloney, CPC
    Data Quality Specialist

  7. #7
    Default Thanks
    Quote Originally Posted by Lliza71 View Post
    Hi cdcpc,
    I don't believe you should use either. 90471 is strictly for immunizations. 90772 is used for therapeutic, prophylactic, or diagnostic, which are not the cases either. I think you would use 11950 - 11954. These are just introduction codes. If you're only doing it for cosmetic, you wouldn't be doing any chemodenervations, diagnosing, or any kind of therapies. I'm no expert, but I would use them., Hope this helps.
    Liza
    Liza,
    That makes a lot of sense. I think 11950-11954 would fit the situation better. Thanks for the help
    Carrie, BS, CPC

  8. #8
    Default
    Quote Originally Posted by magnolia1 View Post
    O.K., maybe I'm missing something here..........
    If these are strictly "cosmetic", why are they being coded?

    If there is an insurance carrier out there who pays for this, please let me know!
    Karen,
    These will be coded just for tracking purposes--they will not be submitted to insurance companies. Being a coder, I like finding the right code for everything! I doubt any insurance would pay for cosmetic Botox injections. Do you have any suggestions on how to bill for the administration?
    Thanks
    Last edited by cdcpc; 01-07-2009 at 12:58 AM. Reason: spelling
    Carrie, BS, CPC

  9. Default Botox
    We use 11950-11954 for injection of filling material (Collagen-Restylan Juvederm).

    Tina

  10. #10
    Location
    Albany, New York
    Posts
    457
    Smile
    Carrie,

    Just trying to "inject" some humor here.

    Like you, I truly doubt any insurance carrier would pay for this procedure.
    Karen Maloney, CPC
    Data Quality Specialist

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