Experts: Code extremity-specific chemodenervation with different codes.
When you code for your physician’s chemodenervation services, you’ll need to know the area that she treated and the specific muscles on which she performed the procedure.
Don’t stop there: If the physician performs chemodenervation on both sides for a patient, your coding will depend on whether you can append modifier 50 (Bilateral procedure) to a code. Your coding will change even further if the physician performs chemodenervation on a patient’s extremities or trunk muscles.
Read on for some extra advice on what to do when chemodenervation coding gets more complicated.
Report Base Codes, Modifier 50 Where Appropriate
For services involving chemodenervation of a somatic nerve, you will choose from one of the following codes, depending on encounter specifics, confirms Amy Turner, RN, BSN, MMHC, CPC, Director of Revenue Integrity at Comprehensive Pain Specialists in Brentwood, Tenn.:
When your physician performs chemodenervation on both sides of the same patient, you’ll need to check the CPT® book for bilateral indications, Turner explains.
Check out this rundown of codes that are, and are not, eligible for coding with modifier 50:
Count Muscles for Extremity Chemodenervation
Your physician might also perform chemodenervation on a patient’s extremities. When this occurs, you’ll want to choose from a different code set, confirms Judith Blaszczyk, RN, CPC, ACS-PM, medical compliance auditor at Auditing for Compliance and Education, Inc. in Overland Park, Kan.
For chemodenervation of a patient’s extremities, you’ll choose from the following codes, depending on encounter specifics:
Remember that you don’t need modifier 50 for these codes, because you report them per extremity, which negates the need for a bilateral procedures modifier.