Summary & Overview
CPT 64617: Percutaneous Laryngeal Chemodenervation, Unilateral
CPT code 64617 denotes a percutaneous chemodenervation of the larynx performed on one side, optionally guided by needle electromyography. This targeted neuromodulatory intervention is used in management of select laryngeal movement disorders and voice dysfunctions, and its proper coding affects coverage, site-of-service decisions, and billing consistency nationwide. Key payers commonly referenced for national policy and reimbursement patterns include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise overview of the clinical procedure captured by the code, common sites of service, and the payers typically responsible for coverage decisions. The publication also summarizes benchmarks and policy considerations that influence utilization and billing practice, highlights documentation elements that support medical necessity, and points to related service and coding contexts for clinicians and billing professionals. Data not available in the input for specific utilization rates, fee schedules, or payer-specific edits is noted where applicable.
Billing Code Overview
CPT code 64617 describes a percutaneous chemodenervation procedure targeting the larynx on one side. The procedure may be guided by needle electromyography when clinically indicated. Service type: Image- or electrophysiology-guided percutaneous therapeutic injection to the laryngeal muscles. Typical site of service: Outpatient procedure suite or ambulatory surgical center; may also be performed in an office setting with appropriate monitoring and equipment.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with unilateral vocal fold dysfunction causing spasmodic dysphonia or focal laryngeal hyperactivity presenting with voice breaks, strain, or breathy dysphonia. The patient is evaluated in a laryngology clinic by an otolaryngologist (ENT) with voice specialty. Office assessment includes history, flexible laryngoscopy, and laryngeal exam to localize the hyperactive muscle (usually thyroarytenoid or lateral cricoarytenoid). Conservative measures (voice therapy, oral medications) have been tried and found inadequate.
In the procedure suite or procedure room, under local anesthesia with or without monitored anesthesia care, the provider performs a percutaneous chemodenervation of one side of the larynx using botulinum toxin injected into the targeted intrinsic laryngeal muscle. Needle electromyography (EMG) guidance may be used to confirm placement and optimize dosing. Postprocedure observation includes brief monitoring for airway or swallowing changes and voice counseling. Follow-up is scheduled to assess effect and plan repeat injections as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when another distinct procedure not normally billed together is performed on the same day and not reported with more specific modifiers. |