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2025 CPT code 64644

Chemodenervation of one extremity; 5 or more muscles.

Do not report diagnostic/therapeutic injections separately. Do not report destruction codes when using non-destructive therapies; use 64999 instead. The supply of chemodenervation agent is reported separately with HCPCS codes (e.g., J0585).

Modifiers may apply. Refer to current CPT guidelines for usage. Modifier TC should be used for the technical component and 26 for the professional component if billing separately.

Medical necessity is established by demonstrating that the procedure is necessary for treating a documented medical condition affecting the nerves and muscles. This may include conditions like spasticity, dystonia, or chronic pain that significantly impacts the patient's function.

The physician injects a pharmacologic compound, such as botulinum toxin or atropine, to interrupt nerve signals, paralyzing the muscles and relieving pain and spasms.

IMPORTANT:For 1-4 muscles in one extremity use 64642. For each additional extremity with 1-4 muscles use add-on code 64643. For each additional extremity with 5 or more muscles, use add-on code 64645. For trunk muscles, use 64646 (1-5 muscles) or 64647 (6 or more muscles).

In simple words: A chemical injection, like Botox, is given into five or more muscles in one arm or leg to reduce pain and muscle spasms.

This code represents the injection of a neurolytic agent, such as botulinum toxin, into five or more muscles in one extremity to treat conditions like spasms or pain. This procedure involves chemically disrupting nerve signals to the muscles.

Example 1: A patient with severe hand spasms due to cerebral palsy receives injections in 5 muscles of the affected arm., A patient with post-stroke spasticity in their leg receives injections in 6 leg muscles to improve mobility., A patient with chronic pain and muscle spasms in their arm following an injury receives injections in multiple arm muscles.

Documentation should include the diagnosis necessitating the procedure, the specific muscles injected, the dosage and type of neurolytic agent used, the extremity treated, and any response to the treatment.

** Always ensure accurate documentation of the number of muscles injected and the specific extremity treated to support the use of this code. Check with individual payers for specific coverage policies. Codes 64642-64645 are reported once per extremity; up to a total of 4 units may be reported.

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