Anesthesia Coding Alert
Submit 64400 for Masseter Muscle Injection
Question: Our pain management specialist wants to administer a bilateral masseter muscle injection. Most of the information I’ve found when trying to confirm the right code is for a Botox injection (CPT® codes 64611 or 64612). At this point, my doctor is looking at a Depo-Medrol injection to this muscle. Should we report the same code as the Botox injection, or would a trigger point code (20552) be more appropriate? New Hampshire Subscriber Answer: The codes you mention, 64611 (Chemodenervation of parotid and submandibular salivary glands, bilateral) and 64612 (Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)) represent chemodenervation. During chemodenervation, the provider uses chemical agents to produce a neuromuscular blockade in order to selectively weaken specific muscles or muscle groups. A provider can use Botox or other chemical agents for this purpose. The masseter muscle is innervated by a division of the trigeminal nerve. Instead of reporting a chemodenervation code, a more accurate option would be 64400 (Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)). Double check with your provider to confirm the reason for the procedure before submitting the claim.
Related Articles
Anesthesia Coding Alert
- Line Placement:
This Simple Checkpoint Will Confirm Whether Separate Swan-Ganz Coding Is Correct
Hint: Location always matters. In most of the cases you code, all the services provided [...] - Line Coding Basics:
All Lines Are Not Created Equal
Here’s how you should code the most common categories. An anesthesia provider often uses multiple [...] - Compliance:
Pay Attention to State Rules in the Post-Pandemic Health World
Note: You’re especially at risk if services cross state lines. If you code for services [...] - Patient Privacy:
Don’t Let Pandemic Priorities Overshadow HIPAA Rules
Brush up on the basics – and associated penalties. If your organization is digging out [...] - You Be the Coder:
Report This for Anesthesia During Nasogastric Tube Placement
Question: I bill for a pediatric hospital. A small child was brought to the OR [...] - Reader Questions:
Submit 64400 for Masseter Muscle Injection
Question: Our pain management specialist wants to administer a bilateral masseter muscle injection. Most of [...] - Reader Questions:
Bill for Time of Canceled Case, but Don’t Include Modifier 53
Question: My provider was scheduled to perform a Vertiflex on a patient in the ASC. [...] - Reader Questions:
Meet the “7 Rules” Before Reporting Medical Direction
Question: I’m new to anesthesia coding. Can you explain the medical direction “rules” I’ve been [...] - Reader Questions:
Don’t Fret Over the Shift to ICD-11 Yet
Question: I listened in on a webinar recently where the speaker said to prepare now [...] - Reader Questions:
Begin in S13 Code Family for Neck Sprain Diagnosis
Question: My pain management specialist treated a patient who was complaining of neck pain. The [...] - Reader Questions:
PCA Placement Isn’t Billable by Anesthesiologist
Question: I have a case in which a patient was not a candidate for a [...]
