Date Posted: April 9, 2026

This Billing and Coding Article has been revised under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: April 9, 2026

Summary of Changes:

Updates were made to the article text under the "Cosmetic Use" and "Modifiers JW and JZ" sections.

Under the ICD-10-CM Codes that Support Medical Necessity section the HCPCs codes describing the specific serotypes have been added to the Group Paragraphs.

Under the ICD-10-CM Codes that Support Medical Necessity section, the group for Paralytic ptosis was removed.

Under the CPT/HCPCS Codes section in Group one the following CPT codes have been added: 76881, 76882 and 76536.

Under the ICD-10-CM Codes that Support Medical Necessity Section, ICD-10 Code N32.81 was added to Group 11.

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