Access DAXXIFY™ is here for your practice and patients
From billing and coding information to patient affordability programs, Access DAXXIFY™ simplifies the process for the entire practice.
What is DAXXIFY®?
DAXXIFY® (daxibotulinumtoxinA-lanm) for injection is supplied as a sterile, preservative-free, white to off-white lyophilized powder in a single-dose vial for intramuscular use after reconstitution.
Each vial contains 100 Units of daxibotulinumtoxinA-lanm, L-histidine (0.14 mg), L-histidine-HCl monohydrate (0.65 mg), polysorbate 20 (0.1 mg), RTP004 peptide (11.7 mcg), and trehalose dihydrate (36 mg).
| j-code | J0589 |
| 10 digit ndc | 72960-112-01 |
| 11 digit ndc | 72960-0112-01 |
| billing units | 100 units |
Payer coverage and benefits investigation
Benefits investigation
Completing a benefits investigation prior to treating a
patient with DAXXIFY® is an important first step
in determining key coverage criteria
applicable to your patient’s individual health plan policy.
Once a benefit investigation is submitted, the Access
DAXXIFY™ program will send the physician a
summary of benefits for your patient.
Billing, coding, and modifiers
Appropriate billing and coding can help assure timely and adequate reimbursement.
The codes provided here are commonly associated with the administration of DAXXIFY®; however, providers should contact the patient’s health plan for specific guidance on coding and site of care requirements before administration.
Healthcare Common Procedure Coding System (HCPCS) Codes
Provider-administered drugs are typically reported with HCPCS Level II J-codes and assigned by CMS.
| Code | Description |
|---|---|
| J0589 | Injection, daxibotulinumtoxinA-lanm, 1 unit [Daxxify®] |
National Drug Codes (NDC)
NDCs are unique numbers that identify a drug's labeler, product, and trade package size.
| 10-Digit Code (5-3-2 format) | 11-Digit Code (-5-4-2 format) | Description |
|---|---|---|
| 72960-112-01 | 72960-0112-01 | DaxibotulinumtoxinA-lanm, 100 Units, single-dose vial |
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Codes
ICD-10-CM is the diagnosis code set used for all healthcare settings for medical claims reporting.
| ICD-10 code | Description |
|---|---|
| G24.3 | Spasmodic torticollis |
| M43.6 | Torticollis |
Current Procedural Terminology (CPT®) Codes
CPT® is the code set used to describe procedures and services performed by healthcare providers.
| CPT Code | Description |
|---|---|
| 64616 | Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) |
| 95873 | Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure). Use in conjunction with 64612-64616 and 64642-64647 |
| 95874 | Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure). Use in conjunction with 64612-64616 and 64642-64647 |
| 76942 | Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation |
Modifiers
Modifiers are 2-digit codes that are added to a CPT® or HCPCS code and used to provide additional information about an item or service provided.
| Modifier | Description |
|---|---|
| 50 | Bilateral (may use when injections occur on the right and left side. Requirements vary by plan) |
| LT | Left Side |
| RT | Right Side |
| JW | Discarded drug not administered |
| JZ | Zero drug wasted (effective July 1, 2023, Medicare plans will require the JZ Modifier to attest that there was no discarded amount from a single vial. Requirements vary by plan) |
| 59 | Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day |
Place of Service (POS) Codes
POS codes are 2-digit numeric codes used to indicate the setting in which a healthcare service was provided.
| POS Code | Description |
|---|---|
| 11 | Office |
| 19 | Off-Campus Outpatient Hospital |
| 22 | Off-Campus Outpatient Hospital |
Medical necessity and appeal resources
The following documents may be helpful during the medical necessity or appeals process
