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Thread: Billing Botox for Migraines

  1. #1
    Join Date
    Apr 2007

    Default Billing Botox for Migraines

    AAPC: Back to School
    I've trying the find the answer to the question do you charge for each injection site? or Per each area injected. For example if a patient had 2 injections in the Corrugator muscles would you charge for the 2 injections or for the 1 area being the Corrugator? I know you bill one code for the area and then you bill for the units of botox used but in terms of pricing the procedure is it by site or area?

  2. #2
    Join Date
    Apr 2007
    Everett, WA


    You would charge for the one site, 64612 no matter how many injections were supplied. Carefully read the code descriptor and that might help you, For example, If during the visit the doctor also injected the procerus and frontalis these would also be included in the submission of the same 64612 code. CPT Assistant has an official ruling on this. ---Suzanne E. Byrum CPC

  3. #3
    Join Date
    Apr 2007
    Grand Rapids, MI


    You might also be able to add the 50 modifier if the injections were done bilaterally. It depends with each payer.

  4. #4
    Join Date
    Apr 2007
    Everett, WA


    This is true, can be a little murky and create a lot of administrative work depending on whether or not they follow MCR guidelines or that of AMA. Still have not resolved the issues fully regarding this issue. Hopefully others might comment .....

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