Neurology & Pain Management Coding Alert

Hint: Keep a count on sides to ethically boost payment.Unlike last year, you can now potentially bill bilateral injections for chemodenervation, earning reimbursement for bilateral injections of Botulinum toxin. Read on for advice on accurately reporting laterality this year. Review Medicare's Status Indicator RevisionEffective January 1, 2012, Medicare switched back the bilateral indicator for codes 64613 (Chemodenervation of muscle[s]; neck muscle[s)] [e.g., for spasmodic torticollis, spasmodic dysphonia]) and 64614 (Chemodenervation of muscle[s]; extremity [s] and/or trunk muscle[s] [e.g., for dystonia, cerebral palsy, multiple sclerosis]). From April 1, 2011, Medicare had assigned bilateral indicator '2' to these codes, implying that these 64613 and 64614 could not be reported as bilateral. For non-disclosed reasons, Medicare is now again switching back to allowing modifier 50 (Bilateral procedure) to be appended to codes 64613 and 64614. The status indicator is now revised to '1' which indicates that these codes can be billed as bilateral. [...]