Neurology & Pain Management Coding Alert

Reader Question:

Spastic Hemiparesis Injections

Question: How many units of 64640 can be billed after injecting different forearm muscles (one limb) for treatment of spastic hemiparesis?

Answer: Code 64640 describes treatment of a peripheral nerve or branch. This includes any number of injections along the nerve. Medicare policy specifically limits payment to one unit per site, regardless of the number of injections made into the site. A site is defined as including the muscles of a single contiguous body part, such as a single limb. Based on this information, code 64640 should be used only once for the treatment of an entire arm.

Editors Note: Answers were provided by Susan Callaway-Stradley, CPC, CCS-P, an independent coding consultant in N. Augusta, SC, and the American Academy of Professional Coders 1998 Coder of the Year.