tci Part B Insider - 2014 Issue 41

Reader Question: Know How to Report Single Blepharospasm Injection

Question: How would I report a Botox injection to control blepharospasm in only one eye? Answer: If the ophthalmologist uses Botox to treat blepharospasm with injections into the skin around one eye, you would use 64612 (Chemodenervation of muscle[s]; muscle[s] innervated by facial nerve [e.g., for blepharospasm, hemifacial spasm]) with modifier LT (Left side) or RT (Right side) on the first line of the CMS-1500 form. Medicare (and payers that follow Medicare guidelines) allow reimbursement for 64612 per eye. So if the ophthalmologist injects Botox for blepharospasm of the right and left eyelids, report 64612-50 (Bilateral procedure). You...

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