Neurology & Pain Management Coding Alert

Question: What is the proper code for injecting different forearm muscles (one arm only) to treat spastic hemiparesis?


Ohio Subscriber

Answer: You should report 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) to describe treating a peripheral nerve or branch. This code includes all injections along the nerve.

Medicare policy specifically limits payment to one unit per site, regardless of the number of injections. A site is defined as including the muscles of a single contiguous body part, such as a single limb. Therefore, report 64640 only once for treating the entire arm.

- Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.