Ophthalmology and Optometry Coding Alert

Question: How should I code for Botox injections to control blepharospasm?Tennessee SubscriberAnswer: For chemodenervation using Botox for blepharospasm (333.81), the uncontrollable contracting of eyelid muscles, use 64612 (Chemodenervation of muscle[s]; muscle[s] innervated by facial nerve [e.g., for blepharospasm, hemifacial spasm]).Medicare payers will allow reimbursement for 64612 per eye. For example, if the ophthalmologist uses Botox to treat blepharospasm with injections into the skin around one eye, you would use 64612 with modifier LT (Left side) or RT (Right side) on the first line of the CMS-1500 form. If he injects Botox for blepharospasm of the right and left eyelids, report 64612-50 (Bilateral procedure).With payers other than Medicare, you should always use two lines when billing multiple procedures -- so in this case, code 64612-RT and 64612-LT.Report the codes per eye (right or left), not per injection. If the ophthalmologist administers more than one injection on the same side, you may still only [...]