Anesthesia Coding Alert

Question: How do I determine the correct units for Botulinum codes J0585 and J0587? The physician injected 100 units of botulinum A and 2,500 units of botulinum B during patient encounters.


Colorado Subscriber
Answer: First, be sure you're reporting the correct botulinum code: J0585 (Botulinum toxin type A, per unit) or J0587 (Botulinum toxin type B, per 100 units).

Then, pay attention to how to bill each type: bill the actual number of units injected with botulinum A (and "wastage" or extra units, if documented). With botulinum B, divide the actual number of units injected by 100 to get your billing units.

Botulinum A example: You have two options for reporting the 100 units of botulinum A that your physician administered. If your software --and the carrier in question -- can accept three digits in Box 24G, report J0585 in Box 24G with 100 billing units. If your software or the carrier cannot accept three digits in the box, report J0585 with 99 billing units in Box 24G, and J0585 with one billing unit in Box 24G as the second line item.

Botulinum B example: Because you bill botulinum B in 100-unit increments, you'll divide the number of units injected by 100. Your physician administered 2,500 units, so report J0587 with 25 billing units in Box 24G.