Wiki Botox Injections - paraspinal muscles

[sheilagoodell]

I have a question on Botox injectons. How would you code these two procedures, after reading the October Coding Edge on Chemodenervation Injections.

PROCEDURE: Botulinum toxin chemodenervation to bilateral shoulder girdle and paraspinal muscles and left lower extremity with EMG guidance.

and

PROCEDURE:
1. Botulinum toxin chemodenervation to left upper and left lower extremities with EMG guidance.



Thank you

 

[ollielooya]

My thoughts are (in light of reading that same great article) that you would use 64613, 64614(51), 95874. Per CMS revision this year CPT 64613 no longer allows the use of modifier 50. And this of course would apply to all the carriers who follow their guidelines. So you'll have to do your homework in checking with the carriers who don't. 64614 CPT code description is pretty clear in the description that "extremity(s)" negate the use of a bilateral indicator and CPT Assistant in an older article confirms.

There are a couple of REAL experts who frequent this forum and hopefully they'll add their comments, suggestions or corrections to what I've furnished.
---Suzanne E. Byrum CPC