OnabotulinumtoxinA (Botox) for Chronic Migraine
What it is
OnabotulinumtoxinA (Botox) is FDA-approved for chronic migraine prevention (≥15 headache days/month). Administered as 155-195 units via 31-39 injection sites every 12 weeks.
ICD-10 Codes
How it works
OnabotulinumtoxinA inhibits SNARE-mediated release of CGRP, substance P, and glutamate from peripheral sensory nerve terminals. It prevents peripheral sensitization of meningeal nociceptors and reduces central sensitization in the trigeminal nucleus caudalis.
What patients need to know
Botox injections for migraine work by blocking pain signals at the nerve endings around your head and neck. Treatments are given every 12 weeks (about 3 months) and can significantly reduce how often you get headaches.
Prior authorization
OnabotulinumtoxinA (Botox) is FDA-approved for chronic migraine (≥15 headache days/month) and is medically necessary after failure of oral preventive medications. Treatment complies with Medicare LCD DL39909 documentation requirements.
Submitting a Botox PA under LCD DL39909?
The PA Engine has Medicare and commercial payer requirements for onabotulinumtoxinA, including PREEMPT trial documentation language. Free, no account required.
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