HCPCS Code J0775: Injection, Collagenase, Clostridium Histolyticum, 0.01 mg

Yes. Medicare coverage is available when the treatment meets medical necessity requirements and is administered by a healthcare provider experienced in the procedure, as outlined in the Xiaflex REMS program.

Documentation should include the diagnosis (e.g., Dupuytren’s contracture, Peyronie’s disease), treatment cycle number, anatomical site (e.g., proximal interphalangeal joint, penile urethra), baseline curvature measurements, and details of the injection procedure.

Many payers, including Medicare Advantage plans, may require prior authorization for J0775. This typically involves submission of the patient’s Peyronie’s Disease Questionnaire or joint contracture measurements.