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Click here for more sample CPC practice exam questions and answers with full rationale

Hyperhidrosis – Billing for Botox

We treated a patient with hyperhidrosis with Botox and billed Aetna cpt codes 64650 & 64653 which were paid. we also billed J0585 @ 200 units which Aetna ultimately denied.
The patients plan requires that they get the Botox through their pharmacy, so our office is not supplying the botox. Should we still bill J0585?

Medical Billing and Coding Forum

Botox injection code

Good day,

The below example has no Anesthesia value to support the code 64644, is there another surgical code that can used to bill for Botox injections that require Anesthesia sedation?

DX: Raynaud’s disease with gangrene PROCEDURE: Botox injection (Left hand)

64644

Chemodenervation of one extremity; 5 or more muscles

-00004

*** ANESTHESIA CARE NOT TYPICALLY REQUIRED ***

Medical Billing and Coding Forum

Split billing for baclofen pump refill by pa with omm or botox by physician

i have been asked this question by our PMR office and they are wanting to have the PA bill for the baclofen pump refill on the same day that the provider will see the patient for OMM or Botox. Is this allowed?
Diane Hyler, CPC/CPMA
[email protected]

Medical Billing and Coding Forum

Pelvic floor Botox injections

I read the only feed I could find on this subject and the suggestion was to call the drug company, which I did, but they had no idea which code to use. My provider wants to start using Botox for trigger injections- currently he is using Lidocaine in a series of 3-4 injections (all separate muscle groups) for IC.

I am deliberating between 64642 and unlisted code 64999.

I originally was looking at 64646/chemodenervation of trunk muscles, but it stipulates to use it only for a select number of trunk muscles and if not listed refers to use 64642/extremity.

I would greatly appreciate any feedback!

Medical Billing and Coding Forum

Botox given to patient same dos as another specialist

Our provider gave Botox 155mg and 45mg JW for waste due to pain in cervical region. Medicare denied due to another ENT provider also billing Botox on same dos in the throat. Our claim is being denied because the ENT already billed the botox on the same dos and was paid. The ENT is a totally separate clinic and specialty, we didn’t know patient even saw that provider. Noridian is saying we need a modifier to bypass but I cannot think of an appropriate modifier in this situation. Do we just appeal the denial without a modifier?

Medical Billing and Coding Forum

Botox treats more medical conditions

So far Botox has only been popular for anti-ageing treatments. This exceptionally potent neurotoxin has found a variety of remarkable uses in modern medicine. The toxin was tested in late 1960’s by Alan Scott and Edward Schantz, who then standardised it for therapeutic use. However it was first used in 1980 to treat for conditions as “Crossed eyes” (Strabismus) a condition where the eyes are not properly aligned and “uncontrollable blinking” (Blepharospasm).   Botox is approved in more than 75 countries for 20 different neurological indications and approved for cosmetic use in more than 40 countries. Let us see how Botox has transformed the lives of many people.

Migraine: Though the efficiency of Botox as a treatment for chronic migraine is under debate, studies have shown that after Botox treatment the pain caused by migraines are dormant for 3 – 4 months and the patient would hardly need any pain killers.

Back Pain: Traditional pain relief medication for back pain may not be effective on many patients. However initial studies have suggested that Botox injections are safe and provide relief to the lower back area without systemic side effects.

Cervical Dystonia: Also known as Spasmodic torticollis is a chronic neurological movement disorder involving the head and neck. Botox treatment is the commonly used to cure this disorder. It disables the movement of the antagonist muscle and allows the agonist muscle to move freely. Patients experience relief for approximately 12 to 16 weeks.

Excessive Sweating: Botox blocks the actions of the nerves that supply the sweat glands and prevents them from producing sweat.

Cerebral Palsy: Botox is injected into muscles that are either spastic or have contractures, the aim being to relieve the disability and pain produced by the inappropriately contracting muscle

Weak Bladder: Medics claim the Botox injected to the bladder wall will improve symptoms in the over 50 age group, impacting on their quality of life. It will assist them to sleep better and be more energetic reducing incontinence and would make a difference to a sufferer’s social life and general health.

Benign Prostatic Hyperplasia: A non-cancerous condition which affects half of males over 60 and is caused by abnormally large prostates. When the prostate enlarges, it squeezes the bladder triggering urinary problems, including the need to go to the toilet frequently during the day and at night. It is a progressive disorder which, if left untreated, can lead to the complete inability to urinate. This, in turn, can cause kidney damage. However, a study by scientists in Taiwan and at the American University of Pittsburgh found that just one Botox jab into the prostate eased symptoms and improved quality of life for three out of four men up to a year later.

Should you suffer from any of the above conditions; it is recommended that you consult your physician to get the correct treatment for your medical condition. The physician that you are consulting should be a qualified well experienced physician who has the knowledge and training to administer Botox cheshire.

Andy Rebeca is passionate about skin care and freelance journalist. Currently working Cheshire Cosmetic LTD and they are specialized for non surgical cosmetic treatments such as, tattoo removal, Dermaroller treatments, sculptra treatments , acne treatments and botox cheshire etc.