Neurology & Pain Management Coding Alert

Question: Our physician is using Botulinum toxin to treat torticollis by injecting in multiple muscles. How do we report this?

Alaska Subscriber

Answer: You report code 64613 (Chemodenervation of muscle[s]; neck muscle[s] [eg, for spasmodic torticollis, spasmodic dysphonia]) for the injection of Botulinum toxin. You may look at what side of the neck your physician is treating and append modifiers RT (Right side) or LT (Left side) accordingly. Look in specific what Botulinum toxin was used by your physician and accordingly report J0585 (Injection, OnabotulinumtoxinA, 1 unit) for Botox, J0586 (Injection, AbobotulinumtoxinA, 5 units) for Dysport, J0587 (Injection, rimabotulinumtoxinB, 100 units) for Myobloc or J0588 (Injection, IncobotulinumtoxinA, 1 unit) for Xeomin.

You see that the codes for Botulinum toxin have includes different quantity of units in the descriptors. You should your physician's documentation to identify the total amount of Botulinum toxin injected and appropriately calculate the number of units of the HCPCS code to bill.

In addition, you report the ICD codes 723.5 (Torticollis, unspecified) or 333.83 (Spasmodic torticollis), depending upon whether or not the torticollis was spasmodic or not.