Collagenase clostridium histolyticum (Xiaflex)

Xiaflex is covered only for adults with FDA‑approved indications — Dupuytren’s contracture with a palpable cord and ≥20° MP/PIP contracture, or men with Peyronie’s disease with a palpable plaque and ≥30° curvature (or ≥15° if previously treated with Xiaflex) — and prior completion of an 8‑injection Peyronie’s course excludes coverage. Coverage requires age ≥18, documented baseline measurements and prior treatment history, administration by an experienced provider, 0.58 mg per injection, and adherence to dosing limits/intervals (Dupuytren’s: ≤3 injections per cord, ≤2 cords/visit, ≥4 weeks between injections, 3‑month approval; Peyronie’s: ≤8 injections per course across ≤4 cycles, 1–3 days between injections in a cycle, ~6 weeks between cycles, 6‑month approval).

"Xiaflex is indicated for the treatment adult patients with Dupuytren's contracture with palpable cord."