Anesthesia Coding Alert

Question: My physician injected five muscles on both sides of the patient's neck, all bilaterally. Can we report 64613 with bilateral modifiers?


Wisconsin Subscriber

Answer: Coding guides state that you should report 64613 (Chemodenervation of muscle[s]; neck muscle[s] [e.g., for spasmodic torticollis, spasmodic dysphonia]) only once, regardless of the number of injections or muscles injected.

Here's why: The code descriptor includes "s" to indicate you use it for single or multiple muscles.

Bonus tip: The 2007 Medicare Physician Fee schedule bilateral status indicator for 64613 is "0," meaning the 150 percent payment adjustment for bilateral procedures does not apply. Additionally, many Medicare carriers have a local coverage determination (LCD) covering chemodenervation services that indicates that they consider the neck to be one single contiguous body part or site.