Coverage Decisions for Medical Technologies & Procedures

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Coverage Decisions for Medical Technologies & Procedures

Botulinum toxin

Coverage decision

L&I covers botulinum toxin injections for specific indications with prior authorization.

Botulinum toxins (BTX) prevent synaptic transmission of acetylcholine resulting in muscle paralysis. BTX injections are used to reduce spasticity or excessive muscular contractions. The injections are intended to relieve pain, assist in posturing and walking, improve range of motion and permit better physical therapy outcomes.

The Food and Drug Administration has approved the following two botulinum toxin products:

Botox ® (BTX-A) is approved for treatment of cervical dystonia, gabellar frown lines, primary axillary hyperhidrosis and strabismus.
Myobloc ® (BTX-B) is approved treatment of cervical dystonia.

Provider Bulletin 05-02 (116 KB PDF).

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