2025 CPT code 64646
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Chemodenervation of trunk muscle(s); 1-5 muscle(s).
Modifiers 22 (Increased Procedural Services), 51 (Multiple Procedures), 59 (Distinct Procedural Service), 73, 74, 76, 77, 78, and 79 (for unplanned or related procedures during the postoperative period), among others, may apply depending on the specific circumstances.
Medical necessity for 64646 must be established by documenting the patient's diagnosis (e.g., spasms, dystonia), failed conservative treatments, and the expected improvement in function and pain relief from the procedure.
The physician is responsible for preparing the patient, administering anesthesia, selecting the appropriate chemodenervating agent (e.g., botulinum toxin, atropine), and injecting it accurately into the targeted trunk muscles (1-5 muscles). The procedure aims to relieve pain and spasms by interrupting nerve signals to the muscles.
In simple words: A doctor injects a medicine into a few muscles in your torso (back, chest, and abdomen) to help relieve muscle pain and spasms. This medicine temporarily paralyzes the muscles to help them relax.
This code represents the injection of a chemodenervating agent, such as botulinum toxin, into one to five trunk muscles to treat pain and spasms. The procedure involves preparing the patient, administering anesthesia, and then injecting the agent into the targeted muscles to disrupt nerve signals and induce paralysis, thereby alleviating symptoms.
Example 1: A patient with back spasms affecting the erector spinae muscles receives injections in three locations using 64646., A patient suffering from abdominal wall spasms due to a neuromuscular disorder receives injections in two abdominal muscles, reported with 64646., A patient experiencing intercostal muscle spasms following a chest injury has botulinum toxin injected into four affected muscles using 64646.
Documentation should include details about the patient's condition, the specific trunk muscles injected, the chemodenervating agent used, the dosage, the injection sites, the response to the treatment, and any complications encountered.Supporting documentation such as EMG findings may also be included.
** Report only one of 64646 or 64647 per session, and ensure appropriate coding for the chemodenervation agent supplied.The iFrameAI product may provide more up-to-date and jurisdiction-specific details on billing and coding guidelines.
- Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) can be used when the physician provides only the technical component of the procedure, such as when the physician does not own the EMG machine used for guidance.
- Specialties:Pain Management, Physical Medicine and Rehabilitation, Neurology, Physiatry, Anesthesiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center