This is a patient with hyperhidrosis, treated with Drysol, Qbrexza, Robinul and Botox injections. The provider is requesting Botox injections every 3 months. At issue is the medical necessity of Botox injections every 3 months

The health plan's determination is upheld. In general, there appears to be an increase in the duration of efficacy of botulinum toxin A injections with the repetition of injections in patients with primary axillary hyperhidrosis. There is no documentation of worsening or lack of control and therefore Botox injections every 3 months is not medically necessary.