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Neurology & Pain Management Coding Alert

Reader Question ~ Weigh Your Choices for Botox and Hyperhydrosis

Published on Thu Oct 26, 2006

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. 
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