CommercialAdministrativeLow impact
08.01.71, Collagenase clostridium histolyticum (Xiaflex ®), collagenase clostridium histolyticum-aaes (Qwo®)
Independence Blue Cross·Plastic Surgery, Urology, Pharmacy·Pharmacy
We identified it
Jun 19, 2026
Summary
This is a routine annual policy reissue with no substantive changes to Independence Blue Cross's coverage of collagenase clostridium histolyticum (Xiaflex for Dupuytren's contracture and Peyronie's disease; Qwo for buttocks cellulite). Coverage criteria, exclusions, REMS requirements, and billing codes remain unchanged. Billing teams should note this policy continues to exclude Qwo as cosmetic and maintains REMS program requirements for Xiaflex Peyronie's disease treatment.
Action Required
No immediate action required. This is a reissue with no changes. Billing team should verify that current system configuration aligns with existing policy: (1) Ensure J0775 is configured for coverage only when used for Xiaflex (Dupuytren's contracture or Peyronie's disease), not Qwo; (2) Verify that claims for Qwo (buttocks cellulite) using J0775 are automatically denied as cosmetic exclusion; (3) Confirm documentation requirements for medical necessity are being collected per policy. No workflow changes needed unless systems are not currently compliant with the stated coverage rules.