tci General Surgery Coding Alert - 2003 Issue 5

Reader Question: Use 64640 for Botox Treatment

Question: How should I code for treatment of an anal fissure with Botox? North Carolina SubscriberAnswer: Botulinum toxin (Botox) is a powerful neuroparalytic agent that paralyzes muscles, which in turn decreases symptoms in patients with muscle spasms. Evidence suggests success in up to 70 percent of cases for use of Botox in treating anal fissures (565.0). For the injection, you should report 64640 (Destruction by neurolytic agent; other peripheral nerve or branch). If the physician employs anoscopy, you may bill this in addition using 46600 (Anoscopy; diagnostic, with or without collection of specimen[s] by brushing or washing [separate...

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