tci Outpatient Facility Coding Alert - 2014 Issue 3

Reader Question: Yes, You Can Have Success Reporting 64642 and 64615 Together

Question:  I have a patient who suffers from migraines and receives treatment with Botox. I’ve been billing 64615/J0585 with no problem. This patient has now suffered a stroke and has related spasticity of an upper limb which requires treatment with Botox as well. The CPT® guidelines for 64615 specifically state that you cannot report this code in conjunction with 64642. However, I’m wondering if I can report 64615, 64642-59, J0585 or 64615, 64642-25, J0585 with the appropriate diagnosis for 64615 and 64642 attached. What do you think? North Carolina Subscriber  Answer:  Coding guidelines for both...

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