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Botox Injections

  1. Default Botox Injections
    Medical Coding Books
    I'm auditing botox injections which is new to me. Can anyone advise on bilateral, multiple eyelids, etc., and calculating the injection units?

  2. #2
    I used to bill for these. From what I remember you can only bill bilateral if you truly did both sides of the body. Like both eyes, both arms, both legs, etc. As far as calculating the injection units - If I remember correctly each bottle of Botox is 100 units so the nurse or doctor should be letting the billing staff know how many units are injected. Also, if the patients are scheduled in a way that you have drug wastage that can billed also.
    Last edited by scorrado; 05-06-2008 at 07:54 AM.
    Susie Corrado, CPC
    ENT Coding/Billing

  3. Default
    Thank you Susie. I'm looking at bilateral as being both eyes regardless of whether upper and lower lids were injected. Does this seem correct? Also I'm interpreting neck and face to be one single body site as in not bilateral since there is only one neck and face anatomically. Is this similar to what you understand or am I incorrect?

  4. #4
    You are correct about the eyes. As far as the other parts of the body we were told that basically the body is cut in half and that is how we determine if it is bilateral. If the patient was having cervical dystonia on both sides of his neck and you injected on both sides that would be bilateral. Same with face - use the nose as the divider. It doesn't happen very often with the face but you will find bilateral alot in the neck. Now that being said that doesn't mean we got paid for the bilateral charge. Some insurances do only recognize the neck as one site - same with face. I literally had a sheet with a list of insurance companies and how they wanted to be billed for Botox. Botox billing is very complicated and not fun and I am so glad we do not do it alot anymore. A good resource for you would be That is a website that Allergon has that helps with reimbursement issues. Hope this info helps - Happy auditing!
    Susie Corrado, CPC
    ENT Coding/Billing

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