CPT® Code 64653

Chemodenervation of eccrine glands refers to a medical procedure aimed at reducing excessive sweating, known as hyperhidrosis, which occurs in specific localized areas of the body. The eccrine glands, which are responsible for producing sweat, are distributed across most regions of the skin. This procedure is particularly indicated for patients suffering from severe focal hyperhidrosis, where the sweating is not generalized but concentrated in specific areas such as the scalp, face, neck, and palms. The process begins with the identification of the affected areas, which is typically done using an iodine solution followed by starch powder. This method allows for the visualization of sweat production, as the areas that sweat will turn dark purple after a short waiting period. Once the areas are marked, the skin is prepared with an antibacterial solution to minimize the risk of infection. The treatment involves the injection of reconstituted botulinum toxin type A into the dermis at intervals of 1.5 to 2 centimeters across the identified regions. It is important to note that CPT® Code 64653 is specifically used for chemodenervation of eccrine glands in areas other than the axillae, and this code can be reported only once per day, regardless of the number of areas treated during that day.