Neurology & Pain Management Coding Alert
Reader Question ~ Weigh Your Choices for Botox and Hyperhydrosis
Question: How should I code a Botox injection for hyperhydrosis?
Nevada Subscriber
Answer: CPT does not have a specific code for this procedure, which means coders--and carriers--have different opinions on the best option.
The American Academy of Dermatology recommends 17999 (Unlisted procedure, skin, mucous membrane and subcutaneous tissue); other coders opt for 64999 (Unlisted procedure, nervous system). Be sure to submit complete documentation with either of these -unlisted- codes.
Some carriers accept 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) for hyperhydrosis.
Some coders opt for 90772 (Therapeutic, prophylactic or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) for the injection and add 64450 (Injection, anesthetic agent; other peripheral nerve or branch) when the neurologist administers an anesthetic during the procedure.
The therapy is new, which is why coding options are so blurred. Work with your carrier to determine the best coding strategy and obtain preapproval before performing the procedure.
Neurology & Pain Management Coding Alert
- Know Your Nerves When Reporting Trigeminal Neuralgia
Learn about nerve structure to help ensure correct codes Understanding the facial nerve structure and [...] - Match Diagnosis With Neurostim Codes--and Avoid Denials
Don't risk losing allowable reimbursement
If your neurologist uses neurostimulation to treat patients- chronic pain, confirm [...] - Know When Neurostimulation Is the Best Option
When a chart for neurostimulation treatment crosses your desk, get the full story before coding [...] - You Be the Coder ~ Bilateral Trigger Point Injections
Question: How should I report bilateral trigger point injections in three locations for a Medicare [...] - Enlist Patient Help to Cover Your Documentation Bases
Hint: Forms and procedures smooth the process
Teaching your neurologist to accurately document a patient's HPI [...] - Reader Question ~ Greater Auricular Nerve = Other Peripheral Nerve
Question: How should I report injections of the greater auricular nerve?
Massachusetts Subscriber
Answer: Look at [...] - Reader Question ~ OP Consult Counts for Nonhospital Visit
Question: If our physician sees a patient in the same- day surgery area of the [...] - Reader Question ~ Check With Physician on Chronic Pain Diagnosis
Question: What is the best diagnosis code for chronic pain syndrome?
Indiana Subscriber
Answer: -Chronic pain [...] - Reader Question ~ Reprogramming Is Key to Pump Coding
Question: What code should I report when my physician checks a patient's infusion pump?
Arizona [...] - Reader Question ~ Follow 3-Year Rule for New Consults
Question: A physician in another practice asked our neurologist to perform a patient consult. We [...] - Reader Question ~ Weigh Your Choices for Botox and Hyperhydrosis
Question: How should I code a Botox injection for hyperhydrosis?
Nevada Subscriber
Answer: CPT does [...] - Reader Question ~ Watch Teaching Rules for TPA Coding
Question: Does CPT include a code for tissue plasminogen activator (TPA)? Our physicians must follow [...]
