CPT® Code 64646

Chemodenervation refers to a medical procedure aimed at reducing involuntary muscle contractions or spasms, particularly in the muscles of the trunk. This technique is commonly utilized for patients suffering from conditions such as dystonia, cerebral palsy, or multiple sclerosis, where muscle control is compromised. The procedure involves the injection of botulinum toxin, either type A or B, directly into the targeted muscle. This toxin works by temporarily paralyzing the muscle, effectively blocking the release of acetylcholine at the peripheral nerve endings. By interrupting the neuromuscular transmission of nerve impulses, the procedure alleviates the symptoms associated with muscle spasms. Prior to the injection, healthcare professionals determine the specific muscles to be treated through methods such as electromyography or physical examination, which includes palpating the muscles and identifying the locations of spasms. The trunk area is then prepared for the procedure, and the selected muscle(s) are injected at precise sites to achieve the desired denervation effect. For coding purposes, the CPT® code 64646 is designated for the treatment of 1-5 trunk muscles, while 64647 is used for procedures involving 6 or more trunk muscles.