Botulinum Toxin Type A & Type B

Botulinum toxin A and B are covered for specified focal muscle, smooth muscle, glandular, and neurologic conditions (including hemifacial spasm, dystonia, spasticity, detrusor overactivity, achalasia for patients >=50 or unfit for surgery, sialorrhoea, hyperhidrosis refractory to topical therapy, chronic migraine meeting diagnostic criteria, and chronic anal fissure refractory to conservative care). Injections are generally effective for about three months and are usually not medically necessary more frequently than every 12 weeks; coverage may be discontinued after two consecutive adequate-dose treatments that fail to produce satisfactory response. Uses not listed in this LCD are investigational and not covered, and providers must follow product-specific approved indications, dosing, and the Billing and Coding guidance (A57474) where applicable.

"Treatment of focal overactive skeletal muscle disorders (e."