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Electrical stimulation for guidance in conjunction with chemodenervation is a procedure that enhances the accuracy of toxin injections into specific muscles. This technique involves the use of a stimulation needle electrode, which is combined with a hypodermic needle that contains the chemodenervation agent. The primary goal of this procedure is to ensure precise localization of the injection site, which is critical for effective treatment outcomes. During the procedure, the physician advances the stimulation needle through the skin and into the targeted muscle area. The stimulating device is then activated, allowing the physician to observe or palpate muscle contractions. This feedback is essential as it helps the physician reposition the stimulation needle as necessary to achieve optimal placement. The manipulation of the needle continues until maximal muscle contraction is achieved with minimal stimulation, indicating that the needle is positioned close to the motor endplate of the nerve. Once the ideal location is confirmed, the chemodenervation toxin is injected as a separate reportable procedure. The physician may also adjust the needle's position by advancing it along the muscle or withdrawing and reinserting it at different sites, repeating the process to ensure the desired therapeutic effect is attained.
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The procedure of electrical stimulation for guidance in conjunction with chemodenervation is indicated for various conditions where precise muscle targeting is essential for effective treatment. The following are the explicitly provided indications for this procedure:
The procedure involves several critical steps to ensure accurate localization of the injection site for chemodenervation. The following procedural steps are outlined:
Post-procedure care involves monitoring the patient for any immediate adverse reactions to the injection. Patients may experience temporary soreness or discomfort at the injection site, which typically resolves within a few days. It is essential for the physician to provide instructions regarding activity restrictions and signs of complications to watch for, such as excessive swelling or unusual pain. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and determine if additional sessions are necessary. Documentation of the procedure and patient response is crucial for ongoing care and future treatment planning.
| Short Descr | GUIDE NERV DESTR ELEC STIM | Medium Descr | ELECTRICAL STIMULATION GUID W/CHEMODENERVATION | Long Descr | Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1E - Lab tests - glucose | MUE | 1 | CCS Clinical Classification | 8 - Other non-OR or closed therapeutic nervous system procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 64612 | MPFS Status: Active Code APC T ASC P3 CPT Assistant Article Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) | 64615 | MPFS Status: Active Code APC T ASC P3 Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) | 64616 | MPFS Status: Active Code APC T ASC P3 Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) | 64642 | MPFS Status: Active Code APC T ASC P3 Chemodenervation of one extremity; 1-4 muscle(s) | 64643 | Addon Code MPFS Status: Active Code APC N ASC N1 Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure) | 64644 | MPFS Status: Active Code APC T ASC P3 Chemodenervation of one extremity; 5 or more muscles | 64645 | Addon Code MPFS Status: Active Code APC N ASC N1 Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure) | 64646 | MPFS Status: Active Code APC T ASC P3 Chemodenervation of trunk muscle(s); 1-5 muscle(s) | 64647 | MPFS Status: Active Code APC T ASC P3 Chemodenervation of trunk muscle(s); 6 or more muscles |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | LT | Left side (used to identify procedures performed on the left side of the body) | 97 | Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | RT | Right side (used to identify procedures performed on the right side of the body) | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Added AMA Guidelines per corrections document dated 2013-03-22. |
| 2011-01-01 | Changed | Short description changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |
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