Otolaryngology Coding Alert

Claims with unlisted-procedure codes require special documentation to explain the procedure performed and the doctor's services. Including a letter with the original claim will speed processing and reimbursement.

For example, a letter regarding a direct Botox injection on a patient may read:

Because no CPT code exists for the physician's services, I am using unlisted-procedure code 64999 (Unlisted procedure, nervous system).

Although the work involved in this procedure is similar to 64613 (Chemodenervation of muscle(s); cervical spinal muscle(s) (e.g., for spasmodic torticollis), the physician injected the vocal cords, rather than the cervical spinal muscle. The service required about the same amount of time and risk.