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Merz Pharmaceuticals Receives J-Code For Xeomin (incobotulinumtoxinA)
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.