Neurosurgery Coding Alert

Question: Can we bill more than one unit for chemodenervation of the eccrine glands (other than the axillae)? Our neurosurgeon sometimes treats the patient's hands and feet on the same date.

Wisconsin Subscriber

Answer: You can bill multiple units on the same date, but keep these tips in mind before filing your claim:

- You normally report chemodenervation of eccrine glands with 64650 (Chemodenervation of eccrine glands; both axillae) or 64653 (- other areas [e.g., scalp, face, neck], per day). These codes are incorrect, however, for your situation. CPT's parenthetical note reminds you to report 64999 (Unlisted procedure, nervous system) for chemodenervation of extremities (hands or feet).

- Carriers might have specific guidelines for reporting the multiple injections. For example, Medicare requests that you bill an injection code multiple times rather than bill the code once and document multiple injection locations. Submit documentation that highlights each area treated to help avoid denials or processing delays