# Admin code for botox



## dcumming (Apr 2, 2014)

What would be the correct admin code for Botox injections for chronic migraines when administered by palptation at R & L cervical neck and trapezius?  Can 64615 be used without the guidance code?  Thanks


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## dwaldman (Apr 2, 2014)

Below is from 2013 April AMA CPT Assistant . Although the article mentions 64613 which has been replaced in 2014. The coding guidance for 64615 is still current. There is not a requirement that guidance is performed to report 64615.

"The new code 64615, Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) was created specifically for reporting chemodenervation of muscles innervated by facial, trigeminal, cervical spinal, and accessory nerves, for the treatment of conditions including chronic migraine"

As a result of a new injection paradigm approved by the Food and Drug Administration (FDA) for the treatment of chronic migraines, a new code (64615) was established for the CPT 2013 code set that describes the injection of muscles innervated by the facial, trigeminal, cervical spinal, and accessory nerves. It was necessary to create code 64615 as the use of codes 64612 and 64613 did not describe the totality of the work performed in this procedure. 

Coding Tip


2014 AMA CPT Assistant January

Other updates to this subsection include: revision of the exclusionary parenthetical note following code 64615, removing the reference to deleted codes 64613 and 64614, and stating that code 64615 should not be reported in conjunction with chemodenervation codes 64612, 64616, 64617, and 64642-64647. A parenthetical note was added following code 64615 to direct users to report codes 95873 and 95874 for guidance, and to clarify that it is not appropriate to report more than one guidance code for 64615. 

Prior to CPT 2014, code 64613 was intended to describe multiple uses of chemodenervation of the neck muscles (eg, spasmodic dysphonia, spasmodic torticollis). The intent of new code 64616 is to report unilateral chemodenervation of the neck muscle(s), excluding those intrinsic to the larynx (eg, for spasmodic torticollis, cervical dystonia). If local anesthesia is performed, it is considered integral to the service. If performed bilaterally, modifier 50, Bilateral Procedure, should be appended.


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## dcumming (Apr 3, 2014)

Thank you,  that helps on the guidance .


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## henleyre1 (Jul 11, 2019)

I have a provider who injects botox b/l for cervical dystonia (64616) but also they injected into the head as well b/l for the headache being caused from the cervical dystonia. 
IS there a separate cpt to code for the botox units injected into the head 64612 or 64615. or does 64616 cover all these muscle 
temporal and currgator are 2 of the injected areas in the head 
help with this is greatly appreciated


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## LisaAlonso23 (Jul 11, 2019)

henleyre1,

Per EncoderPro, report 64615 only once.  64615 refers to the entire destruction procedure that includes multiple injections. 64615 is not to be reported with 64612 or 64615. 

If electrical stimulation or needle electromyography guidance is utilized, use 95873 or 95874.

I hope this helps.


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