# Hyperhydrosis



## ldmadison94@gmail.com (Aug 14, 2012)

I am trying to code Botox injections for hyperhydrosis in the palms and feet.  Do I use 64999?  If so what is the normal charge?


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## jlawler (Aug 15, 2012)

CPT code is 64640 and our fee is $1620.00.  Hope this helps!!!


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## Texascoder64 (Oct 6, 2012)

There is no cpt for the Chemical Denervation of the palms or feet (so you would use the unlisted code cpt 64999  PLUS J0585 x units. For bilateral palms and or feet you will most likely use a 100 u vial for bil palms or feet easily or MORE! You could set your "base" price same as the chem denervation of the axillae code for  the 64999, but be sure to set your base price for each unit on the J code at lease $10 per unit.  (you have to recoup your cost with some profit on the Botox vial, right?)

You will have to check with the commercial payer to get preauthorization or get a pre-determination.
Check with your botox rep - or go to the Botox site on the internet - they provide a packet with pre auth help for these.  

As a rule our practice does not file these as there is alot of work involved to make sure the payer will approve the claim and pay enough to make any kind of profit for the physician.  We "give in" occasionally for the pts.  We prefer to make the pt pay up front and provide them a "medical necessity letter" with the receipt and have the pt get reimbursement on their own.


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