Botulinum Toxins
L33646
Medicare covers botulinum toxin injections for a range of focal neuromuscular and glandular disorders (e.g., spasticity, dystonia, blepharospasm/hemifacial spasm, lower-limb spasticity, achalasia, chronic anal fissure, primary axillary hyperhidrosis, sialorrhea, OAB, and chronic migraine) when documentation shows medical necessity and failure or intolerance of conventional therapies where required. Coverage is subject to site-based payment rules (one injection payment per defined anatomic site), serotype-specific limits after consecutive treatment failures (possible one-year restriction), exclusions for cosmetic use (wrinkles) and spastic smooth-muscle conditions, and requirement to support claims with ICD-10-CM codes listed in Article A52848.
"Botulinum toxin is indicated to reduce spasticity or excessive muscle contractions (including dystonia, spastic hemiplegia/hemiparesis) to relieve pain, improve posture/walking, range of motion, an..."