Anesthesia Coding Alert

Question: I need help in coding correctly for a botulinum toxin injection for pain. What codes should I report?New Hampshire SubscriberAnswer: The HCPCS codes that you should report for the botulinum toxin your provider injected are J0585 (Botulinum toxin type A, per unit) or J0587 (Botulinum toxin type B, per 100 units).Best bet: Check with your provider to verify the reason for the chemodenervation injections because pain (780.96, Generalized pain) is a generic symptom and may not support payer medical necessity.Also, you cannot code the acute pain diagnosis code per the ICD-9 guidelines unless the provider's documentation specifically indicates "acute": "If the pain is not specified as acute or chronic, do not assign codes from category 338, except for post-thoracotomy pain, postoperative pain, neoplasm-related pain, or central pain syndrome."Don't forget: The appropriate injection codes for botulinum toxin injection are the following:• 64612 -- Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (e.g., for blepharospasm, hemifacial spasm)• 64613 -- ... neck muscle(s) (e.g., for spasmodic torticollis, spasmodic dysphonia)• 64614 -- ... extremity(s) and/or trunk muscle(s) (e.g. for dystonia, cerebral palsy, multiple sclerosis).