• CPT for Botox Injection


    What is the difference between using a 64612 vs. CPT 64615 for injection of Botox for blepharospasm?

    Answer:
    The difference is in the full descriptor of the CPT, which specifies the indication for the procedure. From our Coding Coach: The Complete Ophthalmic Coding Reference:

    64612 is for chemodenervation of muscle(s); muscle(s) innervated by facial nerve (eg, for blepharospasm, hemifacial spasm)

    64615 is for chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)

    Use 64612 for blepharospasms. Additional Coding Clues from our Coding Coach for CPT 64612:
    Bilateral procedures will only be considered when both eyes or both sides of the face are injected. In this case, submit the procedure with a 50 modifier. For an ambulatory surgery center (ASC), the appropriate site modifier (-RT and/or -LT) should be appended to indicate if the service was performed unilaterally or bilaterally. Bilateral services must be reported on separate lines using an -RT and -LT modifier (-50 modifier should not be used).