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.

Access DAXXIFY™ and the information contained in this website is intended for informational purposes only and does not represent legal or billing advice. It is the responsibility of the provider and practice to ensure the accuracy of all information and claims that are submitted for reimbursement.

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
10 digit ndc
11 digit ndc
billing units
J0589
72960-112-01
72960-0112-01
100 units

Payer coverage and benefits investigation

DAXXIFY® is a physician-administered, long-lasting neurotoxin.

Payers typically manage physician-administered products through the medical benefit and will create a medical policy that outlines specific coverage criteria.

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.

A patient in search of treatment

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

A patient looking ahead

Access DAXXIFY has options to support your patients