Wiki Help with Botox to Armpits-submitting to ins

[mooneym]

I am having trouble figuring out the correct coding to submit botox to the axilla for hyperhidrosis. One book I have says I can bill for 64650 and the Botox with J0585, but another book I have states the injection of the agent is included with 64650.

I billed 64650 and J0585 to Wellmark and they paid for both codes. The patient is pushing back since she has a higher copay now than if I just billed the 64650. I want to get feedback from my peers before I make a decision and respond.

Thanks for any help you can provide. My email is maren@kochmd.com

 

[ollielooya]

The administration of the injection is included with 64650 yet the botox should be billed separately which it appears you have done. From what I understand the patient WILL definitely have a higher copay as a result. Also, might want to check payer policy.

---Suzanne E. Byrum CPC

 

[mooneym]

Thanks!