1. When used to determine the injection site, EMG or ultrasound services other than G877, G878, G879 or G880 are not eligible for payment with Botulinum toxin services.
2. All Botulinum toxin services are limited to one treatment per condition, per patient every 10 weeks. If, in the opinion of the treating physician, more frequent treatments are necessary, submit claim for manual review with supporting documentation. Authorization will be dependent on the physician demonstrating that the increased frequency of the service is generally accepted as necessary for the patient under the circumstances.