2025 HCPCS code J0586
(Active) Effective Date: N/A Revision Date: N/A Drugs Administered Other than Oral Method - Drugs, Administered by Injection Feed
Injection, abobotulinumtoxinA, 5 Units
Modifiers may be applicable depending on the specific circumstances of the injection. Consult modifier guidelines for appropriate usage.
Medical necessity must be established for each use of J0586. This includes documenting the medical condition being treated and how the injection will address it.Certain payers may have specific requirements or prior authorization procedures.
The physician is responsible for evaluating the patient, determining the appropriate dosage and administration site, ensuring proper injection technique, monitoring for potential side effects, and educating the patient on post-injection care and follow-up.
In simple words: This injection contains a medicine called abobotulinumtoxinA, which helps relax muscles.It's used for conditions where muscles are too active or tense.One unit of the code equals 5 units of the medicine.
AbobotulinumtoxinA is a neuromuscular blocking agent used to treat various medical conditions. One billable unit of J0586 represents 5 units of abobotulinumtoxinA administered via intramuscular injection.
Example 1: A patient with cervical dystonia receives 100 units of Dysport (J0586 x 20 units) via intramuscular injection in the affected muscles., A child with lower limb spasticity receives 100 units of Dysport (J0586 x 20 units) to reduce muscle tightness and improve mobility. The physician carefully assesses the child's condition to ensure the appropriate dose and injection sites., A patient with chronic migraine receives prophylactic injections of Dysport (J0586) every 12 weeks. The physician documents the frequency, dosage, and injection sites, along with the patient's response to the treatment.
Documentation should include the diagnosis, dosage, frequency, injection sites, medical necessity (especially for cosmetic use), prior authorization (if required by the payer), and patient response to treatment.
** J0586 represents the drug only, not the administration.Separate codes may be required for the administration procedure. Always check with specific payer guidelines for coverage policies, prior authorization requirements, and any applicable modifiers.
- Revenue Code: 0636, 0250
- Specialties:Neurology, Physical Medicine and Rehabilitation, Ophthalmology, Pain Management, Urology, Dermatology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Independent Clinic, and others based on the specific scenario.