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Guest
#1 Posted : Wednesday, May 25, 2022 11:32:28 AM(UTC)
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Guest

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IS there a code for Botox injections for TMJ therapy? I inject botox when pt's have trismus or are experiencing pain due to TMJ issues.
courtneydsnow
#2 Posted : Thursday, May 26, 2022 10:58:53 AM(UTC)
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courtneydsnow

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Hi Guest!

Yes there is! The most common ones used for dental practices are J0585 (for the botox drug itself) and 64615 (for the injection procedure). However, just a heads up that many medical insurers list botox for treatment of TMJ disorders as currently "experimental & investigational".

A few important notes/main points:
• Most medical insurers currently list botox as “experimental & investigational” for a diagnosis of TMJ disorder (M26.601 - M26.69).
• Some medical insurers will cover botox for “painful bruxism” (i.e. Aetna), but patient must have had an inadequate response to:
• A night guard
• Pharmacologic therapy such as diazepam
• Some medical insurers will cover botox for “Myofascial Pain Syndrome”, but patient must have tried & failed:
• Physical therapy
• Trigger point injection (Injection of local anesthetics & corticosteroids)
• Many medical insurers cover botox for chronic migraines, but:
• Must meet chronic criteria (i.e. at least 15 days/mo)
• Must have tried & failed medication attempts (typically 3)
• Other indications include “first bite syndrome (when failed relief from analgesics, antidepressants or anticonvulsants) and “excessive salivation” (when refractory to pharmacotherapy)



Botox Type A:
HCPCS codes:
• J0585 - Botulinum toxin type A, per unit [Botox]
• J0586 - Injection, Abobotulinumtoxina, 5 units [Dysport]
• J0588 - Injection, incobotulinumtoxinA, 1 unit [Xeomin]

CPT Codes:
• 64611 - Chemodenervation of parotid and submandibular salivary glands, bilateral
• 64612 - Chemodenervation of muscles(s); muscles(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)
• 64615 - Chemodenervation of muscles(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)
• 64616 - Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)
• 64617 - larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed
• 64653 - Chemodenervation other area(s) (e.g., scalp, face, neck), per day
• 95873 - Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure)
• 95874 - Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure)


Botox Type B:
HCPCS Code:
• J0587 - Botulinum toxin type B, per 100 units

CPT Codes:
• 64616 - Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)
• 95873 - Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure)
• 95874 - Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure)


Hope this helps!
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