Merz Pharmaceuticals Receives J-Code For Xeomin (incobotulinumtoxinA)
January 10, 2012
Permanent Product-Specific Code Will Help Simplify Billing And Reimbursement GREENSBORO, N.C., January 4, 2012 /PRNewswire/ — Merz Pharmaceuticals, LLC, today announced that the Centers for Medicare and Medicaid Services (CMS) has assigned a product-specific Healthcare Common Procedure Coding System (HCPCS) billing code, J0588 “INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT” for Xeomin® (incobotulinumtoxinA), effective beginning January 1, 2012.
The U.S. Food and Drug Administration (FDA) approved XEOMIN in July 2010 for the treatment of cervical dystonia in adults, to decrease the severity of abnormal head position and neck pain in both botulinum toxin-naive and previously treated patients, and blepharospasm in adults who have been previously treated with Botox (onabotulinumtoxinA).
“We are so pleased that CMS granted a permanent product-specific code for XEOMIN,” said Janet Hieshetter, Executive Director of the Dystonia Medical Research Foundation (DMRF). “This milestone reinforces the importance of ensuring access to all available treatment options. The DMRF congratulates Merz on this achievement and applauds their ongoing dedication to patient and physician support.”
Merz is committed to supporting patients and physicians in the cervical dystonia and blepharospasm community. In addition to offering services such as the industry-leading Co-pay Assistance Program, which helps alleviate patient out-of-pocket expenses, XEOMIN’s list price has been reduced by nearly 20 percent, effective October 6, 2011, in an effort to ensure access to therapy for the greatest number of patients.
XEOMIN is the only botulinum neurotoxin that requires no refrigeration prior to reconstitution and can be stored at room temperature for up to 36 months. XEOMIN is also the only type A botulinum neurotoxin that is available in 50-unit single use vials that may allow for a reduction in wastage and may minimize patient out-of-pocket expenses.
“This is a significant milestone for Merz and it complements our ongoing efforts to ensure broad access for patients who have come to rely on this highly refined molecule,” said Jack Britts, President and CEO of Merz Pharmaceuticals, LLC. “We are confident that the availability of this product-specific code will assist in streamlining billing and reimbursement for XEOMIN.”
When the permanent code, J0588, goes into effect on January 1, 2012, Merz expects most payors will adopt the new code; however, providers are encouraged to verify preferred coding through the XEOMIN Customer Support Program (1-888-4-XEOMIN) or directly with individual payors prior to billing XEOMIN for treatment that occurs on or after January 1, 2012.
Until individual government contractors, state Medicaid agencies and commercial payors update their systems to recognize the newly assigned J-Code, the Q-Code will continue to act as a product-specific reimbursement code for XEOMIN. In most circumstances, utilizing a product-specific Q-Code is administratively identical to billing under a permanent J-Code. Still other payors may not have adopted Q2040 and if they do not have their systems updated by January 1, the use of a miscellaneous J-Code (such as J3590/J3490) may be necessary.
XEOMIN is a registered trademark of Merz Pharma GmbH & Co KGaA.
Botox is a registered trademark of Allergan, Inc.