How To Use CPT Code 64643

CPT 64643 describes the use of chemodenervation to relieve pain and spasms in one to four muscles of an additional extremity. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64643?

CPT 64643 is used to describe the injection of a chemical, such as Botox, into one to four muscles of an additional extremity after the initial injection in order to relieve pain and spasms. This code is an add-on code and should be reported in addition to the primary code for the initial extremity.

2. Official Description

The official description of CPT code 64643 is: ‘Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT codes 64642 and 64644.

3. Procedure

1. After injecting the muscles of one extremity, the healthcare provider administers a pharmacologic compound, such as botulinum toxin or atropine, to interrupt the nerve signals that activate a muscle in an additional extremity.

4. Qualifying circumstances

CPT 64643 is used when a patient experiences pain and spasms in one extremity and requires chemodenervation in one to four muscles of an additional extremity. The procedure is performed by a healthcare provider and involves the use of a pharmacologic compound to paralyze the muscles and provide relief.

5. When to use CPT code 64643

CPT code 64643 should be used when a patient requires chemodenervation in one to four muscles of an additional extremity after the initial injection in order to relieve pain and spasms. It is important to report this code in addition to the primary code for the initial extremity.

6. Documentation requirements

To support a claim for CPT 64643, the healthcare provider must document the following information:

• The need for chemodenervation in one to four muscles of an additional extremity
• The specific pharmacologic compound used
• Date of the procedure
• Start and end time of the procedure
• Details of the muscles injected
• Progress made by the patient
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 64643, ensure that the procedure is performed by a qualified healthcare provider and that the appropriate documentation is provided. This code should be reported in addition to the primary code for the initial extremity. It is important to follow any specific guidelines provided by the payer regarding the use of this code.

8. Historical information

CPT 64643 was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates to the code since its addition.

9. Examples

1. A patient receives an injection of Botox in one muscle of their arm to relieve pain and spasms. The healthcare provider then administers an additional injection in two muscles of their leg to further alleviate symptoms.
2. After injecting a pharmacologic compound into one muscle of a patient’s back, the healthcare provider proceeds to inject three muscles in their neck to provide additional relief from pain and spasms.
3. A patient undergoes chemodenervation in one muscle of their hand to address pain and spasms. The healthcare provider then administers injections in four muscles of their foot to further alleviate symptoms.
4. Following an initial injection in one muscle of a patient’s shoulder, the healthcare provider proceeds to inject two muscles in their hip to provide additional relief from pain and spasms.
5. A patient receives an injection of a pharmacologic compound in one muscle of their leg to address pain and spasms. The healthcare provider then administers an additional injection in four muscles of their arm to further alleviate symptoms.
6. After injecting a pharmacologic compound into one muscle of a patient’s neck, the healthcare provider proceeds to inject three muscles in their back to provide additional relief from pain and spasms.
7. A patient undergoes chemodenervation in one muscle of their foot to address pain and spasms. The healthcare provider then administers injections in two muscles of their hand to further alleviate symptoms.
8. Following an initial injection in one muscle of a patient’s hip, the healthcare provider proceeds to inject four muscles in their shoulder to provide additional relief from pain and spasms.
9. A patient receives an injection of a pharmacologic compound in one muscle of their arm to address pain and spasms. The healthcare provider then administers an additional injection in three muscles of their leg to further alleviate symptoms.
10. After injecting a pharmacologic compound into one muscle of a patient’s back, the healthcare provider proceeds to inject two muscles in their neck to provide additional relief from pain and spasms.