Neurosurgery Coding Alert

Reader Question:

Check Chemodenervation Codes For Botulinum Injections

Question: In a patient with chronic migraine with no aura and no status migrainosus, our physician administered 140 units of Botulinum toxin. How can we report this service?

New Mexico Subscriber

Answer: Your physician performed a chemodenervation with the botulinum toxin. You’ll submit code 64615 (Chemodenervation of muscle[s]; muscle[s] innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral [e.g., for chronic migraine]) for the chemodenervation. Also, report HCPCS code J0585 (Injection, onabotulinumtoxin A, 1 unit) x 140 for the Botox injection. Remember to bill for 140 Units that your physician used. Lastly, submit G43.709 (Chronic migraine without aura, not intractable, without status migrainosus) for the diagnosis of the patient’s migraine.