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CPT®
64614

CPT® Code 64614
Deleted

Code deleted, see 64642, 64643, 64644, 64645, 64646, 64647

Official Description

Chemodenervation of muscle(s); extremity and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple sclerosis)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Chemodenervation refers to the process of using neurotoxins or chemodenervation agents to inhibit the function of specific muscles. This procedure is commonly performed on muscles located in the extremities or trunk. The primary purpose of this intervention is to alleviate symptoms associated with various neurological conditions, such as dystonia, cerebral palsy, and multiple sclerosis. Dystonia is characterized by involuntary muscle contractions that can lead to abnormal postures and movements, while cerebral palsy is a group of disorders affecting movement and muscle tone, often due to brain damage occurring before or during birth. Multiple sclerosis is a chronic disease that affects the central nervous system, leading to a range of symptoms including muscle weakness and spasms. By injecting these agents into targeted muscles, the procedure aims to reduce muscle overactivity, improve function, and enhance the quality of life for individuals suffering from these debilitating conditions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of chemodenervation of muscle(s) is indicated for the treatment of various neurological and muscular disorders. The following conditions are explicitly mentioned as indications for this procedure:

  • Dystonia - A movement disorder characterized by sustained muscle contractions, abnormal postures, and twisting movements.
  • Cerebral Palsy - A group of disorders affecting movement and muscle tone, often resulting from brain damage that occurs before or during birth.
  • Multiple Sclerosis - A chronic disease that affects the central nervous system, leading to symptoms such as muscle weakness, spasms, and coordination difficulties.

2. Procedure

The procedure for chemodenervation involves several key steps to ensure effective treatment. Each step is crucial for the successful administration of the neurotoxin or chemodenervation agent.

  • Step 1: Patient Assessment - Prior to the procedure, a thorough assessment of the patient's medical history and current symptoms is conducted. This evaluation helps determine the appropriateness of the chemodenervation treatment and identifies the specific muscles that require intervention.
  • Step 2: Preparation - The treatment area is prepared by cleaning the skin to minimize the risk of infection. The healthcare provider may also mark the injection sites based on the assessment of muscle overactivity.
  • Step 3: Injection - Using a fine needle, the neurotoxin or chemodenervation agent is injected directly into the targeted muscles. The dosage and number of injection sites depend on the severity of the condition and the specific muscles involved. Care is taken to ensure accurate placement to achieve the desired therapeutic effect.
  • Step 4: Monitoring - After the injections, the patient is monitored for any immediate adverse reactions. This may include observing the patient for signs of weakness or discomfort in the treated area.

3. Post-Procedure

Following the chemodenervation procedure, patients are typically advised on post-procedure care to optimize recovery and outcomes. It is common for patients to experience some temporary weakness in the injected muscles, which is expected as the neurotoxin takes effect. Patients may be instructed to avoid strenuous activities for a short period to allow the muscles to adjust. Follow-up appointments are often scheduled to assess the effectiveness of the treatment and to determine if additional injections are necessary. Patients should also be informed about potential side effects, such as localized pain or bruising at the injection site, and advised to report any unusual symptoms to their healthcare provider.
Short Descr DESTROY NERVE EXTREM MUSC
Medium Descr CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE
Long Descr Chemodenervation of muscle(s); extremity and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple sclerosis)
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory 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 Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6C - Minor procedures - other (Medicare fee schedule)
MUE Not applicable/unspecified.
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures
Date
Action
Notes
2014-01-01 Deleted Code deleted, see 64642, 64643, 64644, 64645, 64646, 64647
2013-01-01 Changed Description Changed
2011-04-04 Changed Bilateral surgery indicator changed to 2
2011-01-01 Changed Short description changed.
2001-01-01 Added Code added.
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