2025 CPT code 64643
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure)
Modifiers may be applicable. Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity must be established by documenting the patient's functional limitations and pain due to the muscle spasms, along with failed attempts at less invasive therapies. The documentation should demonstrate how the chemodenervation will improve the patient's condition.
The physician performs the injection of the neurolytic agent into the specified muscles of the additional extremity, ensuring proper localization and dosage.
In simple words: The doctor injects a medicine into 1 to 4 muscles in an additional limb (like an arm or leg) to help stop pain and muscle spasms.This is done after injecting a first limb. The medicine works by blocking nerve signals that make muscles move.
This add-on code describes the injection of a neurolytic agent, such as botulinum toxin or atropine, into 1-4 muscles of an additional extremity (after the first extremity) to interrupt nerve signals, causing muscle paralysis, and thereby relieving pain and spasms.It is used in conjunction with 64642 (for the initial extremity).
Example 1: A patient with spasticity in both legs receives injections in 3 muscles in the right leg (first extremity treated, coded as 64642) and 2 muscles in the left leg (additional extremity, coded as 64643)., A patient with cerebral palsy has muscle spasms in one arm and one leg. The arm is treated first (64642), followed by the leg (64643)., A patient with post-stroke spasticity receives injections in their right arm (64642). Due to increasing spasticity in their left arm, they later receive injections in 2 muscles in the left arm (64643).
Documentation should include: the diagnosis causing the spasms or pain; the specific muscles injected; the number of muscles injected per extremity; the name and dosage of the neurolytic agent used; and a description of the patient's response to the procedure.
** The supply of the chemodenervation agent should be reported separately using the appropriate HCPCS code (e.g., J0585 for Botulinum toxin type A).
- Payment Status: Active
- Specialties:Neurology, Physical Medicine & Rehabilitation, Pain Management, Physiatry
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center