Author Topic: CPT code for botox injection of thoracic paraspinal & upper trapezius muscle  (Read 1955 times)

thatcuteblonde

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Does any one know what the proper CPT code to bill the following scenario would be?
Procedure: Trigger point injections 8 locations in thoracic and cervical paraspinal muscles and upper trapezius. Injected with Botox re-constituted to 12.5 units per cc utilitzing strict sterile technique and a 27g needle.
It was submitted to me at 64999 x 3 units, however I believe the cervical injection should be billed using 64613 and the after some research have seen somethe following:

CPT Assistant states that 64613 should only be reported once regardless of the number of injections or muscles injected due to the use of the plural (s) in the code description

Additionally, Medicare carriers that have LCD for botulinum toxin injections also take the stance that chemodenervation of the cervical muscle(s) should only be reported once as the neck is considered one site or contiguous unit

I am billing a Workers Compensation Case and am not sure how this should be billed. I think at the very least, it should be billed as 64613 x1 unit and 64999 x2 units but I am unsure. Does any one have any suggestions or thoughts on this?