Botox

I had asked this question the other day but nobody responded. Does anyone know the CPT® code to use for Botox injection? We usually charge but this patient had it done to axillae for hidradenitis and wants us to try billing her insurance.

re: Botox

I've only billed botox (J0585) for migraine treatment.

We use the chemodenervation codes. I would look at 64614 for the armpit. If it was done to both sides, bill with bilaterial modifier.

re: Botox

Try 64650 (Chemodenervation of eccrine glands; both axillae). The physician administers a neurotoxin to the eccrine glands to reduce hyperhydrosis (excessive sweating). The skin area to be injected is identified by applying iodine to the skin followed by a light dusting with cornstarch. The resulting chemical change caused by the patient's perspiration turns the area black. Botulinum toxin type A (BTX-A, Botox(R)) is injected intradermally into the site with a series of injections, usually 10 to 15 injections per axilla, via a Teflon-coated 23- to 26-gauge electromyogram (EMG) needle with syringe. Since the sweat glands are between the dermis and the dermal fat tissue, the injections must be precise. BTX-A must be injected deep enough to reach the nerve endings but not so deep as to go into the fat. Report 64650 for eccrine glands of both axillae.

Because these procedures are usually not done out of medical necessity, the patient may be responsible for charges. Verify with the insurance carrier for coverage. Surgical trays, A4550, are not separately reimbursed by Medicare; however, other third-party payers may cover them. Supplies used when providing this procedure may be reported with J0585, J0587, and J0588. Check with the specific payer to determine coverage.

I hope this helps!