2025 CPT code 64615
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Chemodenervation of muscle(s) innervated by facial, trigeminal, cervical spinal, and accessory nerves, bilateral (e.g., for chronic migraine).
Modifiers may be applicable. Refer to official CPT guidelines for specific modifier usage.
Medical necessity for 64615 is established by the presence of a diagnosed condition, such as chronic migraine, that warrants chemodenervation.Specific payer policies should be consulted.
The physician locates the overactive muscles, often using EMG guidance, and injects the chemodenervation agent bilaterally into the targeted muscles.
In simple words: This procedure involves injecting a chemical, usually Botox, into specific muscles on both sides of the head and neck to temporarily paralyze them. It's used to treat chronic migraines by blocking nerve signals that cause muscle spasms.
Bilateral chemodenervation of muscles innervated by the facial, trigeminal, cervical spinal, and accessory nerves is performed. This procedure is often used for the treatment of chronic migraine. Electromyography (EMG) guidance may be used to locate the targeted muscles.The injection of other therapeutic agents (e.g., corticosteroids) is included in the code.
Example 1: A patient with chronic migraine headaches (15 or more headache days per month) undergoes bilateral chemodenervation of the muscles innervated by the facial, trigeminal, cervical spinal, and accessory nerves using botulinum toxin., A patient with intractable chronic migraine unresponsive to other treatments receives bilateral injections of botulinum toxin into the specified muscle groups under EMG guidance., A patient with chronic migraine and coexisting cervical dystonia receives bilateral chemodenervation of the targeted muscles; however, the injections for the cervical dystonia are coded separately.
Documentation should include the diagnosis, dosage and frequency of injections, specific injection sites, and documentation supporting medical necessity.
- Specialties:Neurology, Pain Management, Anesthesiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center