Botulinum Toxins

Botulinum toxin products Botox, Dysport, Xeomin, Myobloc, and Daxxify are covered when used for their FDA‑labeled indications and for specific off‑label uses listed in the LCD (notably multiple neurologic and GI indications for Botox and select off‑label Dysport uses). Coverage excludes cosmetic uses (including Jeuveau), certain anatomic injections (esophageal body), isolated lower limb dystonia, abductor spasmodic dysphonia, and use in patients with contraindications; product interchangeability is not allowed and documentation supporting diagnosis, prior therapies, and medical necessity must be retained for audit.

"Botulinum toxin products (onabotulinumtoxinA/Botox, abobotulinumtoxinA/Dysport, incobotulinumtoxinA/Xeomin, rimabotulinumtoxinB/Myobloc, daxibotulinumtoxinA/Daxxify) are covered when administered f..."

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