Treatment Overview

Treatment options available to patients with primary hyperhidrosis can be categorized as:
1) Non-surgical such as topical antiperspirants, iontophoresis, topical anticholinergics including cloths, targeted alkali thermolysis delivered via an in-office, 3-minute-application patch, and systemic medications.  (An expert-led webinar about oral medications to treat hyperhidrosis, can be viewed here.)
2) Minimally invasive. Botulinum toxin injections, which can be said to be “minimally invasive,”[99] have become a therapy for patients who fail to respond to more-conservative treatment prior to resorting to surgery.[29,99] Similarly, the miraDry medical device is minimally invasive and uses thermolysis to destroy the sweat glands of the underarms and stop underarm sweating. (A webinar discussing miraDry is available for you to watch anytime.)
3) Surgical such as excision of axillary tissue and endoscopic thoracic sympathectomy. [9

Each therapeutic option differs by duration of efficacy, side effects, and response rate in the various anatomic areas treated.[9,29,97] You can learn more details about each treatment modality on the corresponding pages of this site. 

Quick reference chart for ICD10 and CPT codes

For help with your office's insurance and reimbursement process, we've developed a handy chart with the latest ICD-10 and CPT codes for hyperhidrosis and hyperhidrosis treatments. The chart is provided below.

ICD-10 Codes:

  • L74.510 - Primary focal hyperhidrosis, axilla
  • L74.511 - Primary focal hyperhidrosis, face
  • L74.512 - Primary focal hyperhidrosis, palms
  • L74.513 - Primary focal hyperhidrosis, soles
  • L74.519 - Primary focal hyperhidrosis, unspecified
  • L74.5 Focal hyperhidrosis
  • L74.51 Primary focal hyperhidrosis
  • L74.52  - Secondary Focal Hyperhidrosis
  • L74.8 Other eccrine sweat disorders
  • L74.9 Eccrine sweat disorder, unspecified
  • R61 - Generalized Hyperhidrosis R61 

CPT Codes

for Treatment of Hyperhidrosis with Botulinum toxins:
• Face/Head Primary Hyperhidrosis: 64653 
• Plantar and/or Palmar Primary Hyperhidrosis: 64999 
(May require manual processing.)
• Axillary Primary Hyperhidrosis: 64650 
• Botulinum toxin: J0585 (Bill per unit of toxin, per axilla. If billing for >99 units, check to be sure system can accept/recognize 3-digits. If not, bill for 99 units, and then for the balance separately.)

CPT Codes for Treatment of Hyperhidrosis with Iontophoresis: 
• for each 15-minute session 97033


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