AAPC - Back to school
Results 1 to 5 of 5

Thread: botox injection if a provider administers

  1. #1

    Default botox injection if a provider administers

    AAPC: Back to School
    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.

  2. #2


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

  3. #3
    Join Date
    Apr 2007
    Everett, WA


    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

  4. #4

    Default 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?

  5. #5
    Join Date
    Apr 2007
    Reno, Nevada


    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.

Similar Threads

  1. Botox injection
    By dpetersen in forum Family Practice
    Replies: 2
    Last Post: 02-03-2014, 04:59 PM
  2. Botox injection
    By kumeena in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 08-20-2013, 07:11 AM
  3. Botox Injection
    By tfischer in forum Dermatology
    Replies: 3
    Last Post: 03-25-2010, 10:24 AM
  4. Cystoscopy with botox injection
    By ms123 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 10-14-2009, 05:28 AM
  5. Botox injection
    By dowero in forum General Surgery
    Replies: 1
    Last Post: 04-28-2008, 06:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.