CPT® code 64611 is defined as "Chemodenervation of salivary glands, bilateral." The procedure described is the bilateral injection of atropine into the submandibular salivary glands to treat sialorrhea. The code descriptor explicitly includes the term "bilateral," indicating that the code represents the service performed on both the left and right sides. Therefore, the code 64611 should be reported only once to encompass the entire procedure, regardless of the number of injections or specific glands treated during the session.

B. 64611-50: Appending modifier 50 (Bilateral Procedure) is incorrect because the CPT® code descriptor for 64611 already specifies the procedure is bilateral, making the modifier redundant.

C. 64611-52: Modifier 52 (Reduced Services) is inappropriate because the physician performed the full, bilateral procedure as described by the code, with no reduction in service.

D. 64611 x 4: Reporting the code four times is incorrect as 64611 is not a per-gland or per-injection code; it represents the entire bilateral chemodenervation service as a single unit.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Page 530: The descriptor for code 64611 is "Chemodenervation of salivary glands

bilateral."

Appendix A

Modifier 50: "Unless otherwise identified in the listings

bilateral procedures that are performed at the same session should be identified by adding modifier 50 to the appropriate 5-digit code." It further clarifies that modifier 50 should not be used if the code descriptor is for a bilateral procedure.

2. AAPC. (2023). 2024 CPC Official Study Guide.

Chapter 12

Nervous System: This chapter explains the proper application of codes for chemodenervation. It reinforces that codes with "bilateral" in their description

such as 64611

should not have modifier 50 appended

as the bilateral nature is already included in the code's valuation and definition.