Medical Billing Forum

Coding => Coding => Topic started by: jaks97 on March 19, 2011, 10:34:33 AM

Title: 64613
Post by: jaks97 on March 19, 2011, 10:34:33 AM
Doing ASC coding, Dr does Chemodenervation of muscles of facial nerve, neck muscle, & muscles of extremity. He will do different muscles, and his op report will say: Botox x 16 and previous coder who was certified would bill for example:
64613  x 16 units.....we have now outsourced this position, and they are saying to only use 64613 one time no matter how many muscles.....DR is saying that is not correct.....Help , who is correct I am the office manager and not a coder...

Title: Re: 64613
Post by: pattil88 on March 20, 2011, 07:41:49 AM
Here's a link from the American Academy of Neurology that may help:

http://www.aan.com/news/?event=read&article_id=4746

Looks like this is payer-driven as to the # of units to report. In my experience, when the CPT surgery code description specifies "each nerve" or "each muscle" in the description, then # of units is probably appropriate if multiple sites are performed.  I don't see the term "each" in the code descriptions from 64612-64614.
Title: Re: 64613
Post by: oneround on March 23, 2011, 02:18:39 PM
Correct, the key word in the description is 'muscle(s) which means you would report this code 1 time if if it were done on 20 muscles.  Patti was correct in stating that when coding multiple procedures sometimes the code (which is usually an 'add on' code) will state each additional as in code 64627.  64613 is appropriate for your info given.