In simple words: This code covers Xeomin, a medication injected into muscles to reduce muscle activity or spasms. It's used to treat conditions like muscle stiffness, excessive blinking, neck spasms, and drooling. It can also be used for cosmetic purposes, like reducing frown lines.

IncobotulinumtoxinA is a botulinum toxin type A that blocks nerve activity in muscles, reducing muscle activity. This code represents one unit of incobotulinumtoxinA administered via intramuscular or intraglandular injection for conditions like upper extremity spasticity, cervical dystonia, blepharospasm, and chronic sialorrhea.It is also used cosmetically to treat frown lines, though this use is often not covered by insurance.

Example 1: A patient with cervical dystonia receives injections of incobotulinumtoxinA into affected neck muscles to relieve muscle spasms and improve head position., A patient with blepharospasm (uncontrollable eyelid twitching) receives incobotulinumtoxinA injections around the eye to reduce spasms and improve eye function., A patient receives incobotulinumtoxinA injections in the forehead to reduce the appearance of frown lines (cosmetic use).

Documentation must support medical necessity and include the diagnosis, dosage, injection sites (with diagram), number of units injected and discarded, and any relevant prior treatment information. For cosmetic use, documentation should avoid cosmetic terminology and diagrams.

** Prior authorization may be required by some payers, particularly for hospital outpatient department services.Always verify coverage and prior authorization requirements with the payer before providing treatment.