Primary Care Coding Alert
Don’t Sweat This Hyperhidrosis Chemodenervation Code Choice
Question: Our internist performed intradermal injections of botulinum toxin on a patient suffering from primary palmar hyperhidrosis, and I am not sure of the correct CPT® code to use for this service. Would 96372 be appropriate? Or is 64653 a better choice? AAPC Forum Participant Answer: Primary palmar hyperhidrosis, or excessive palm sweating, is often treated by injecting botulinum toxin intradermally or subdermally in the patient’s palms in a process known as chemodenervation. To document the procedure, you’ll use 64999 (Unlisted procedure, nervous system) for chemodenervation of extremities, such as the hands or feet along with L74.512 (Primary focal hyperhidrosis, palms) to accompany the procedure code. Why? An instructional parenthetical note for 64653 (Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day) tells you to use 64999 for chemodenervation of extremities (e.g., hands or feet). This instruction means that neither 64653 or 96372 (Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular) would be correct code choices to describe this procedure.
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