G51.33: Clonic hemifacial spasm, bilateral
G51.33, clonic hemifacial spasm, bilateral, is listed as a covered diagnosis in 16 Medicare billing and coding articles that apply to 18 HCPCS Level II codes, including J0585 (Injection, onabotulinumtoxina, 1 unit), J0588 (Injection, incobotulinumtoxin a, 1 unit), J0586 (Injection, abobotulinumtoxina, 5 units). The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with G51.33 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 8 |
| J0588 | Injection, incobotulinumtoxin a, 1 unit | Carrier judgment | — | 8 |
| J0586 | Injection, abobotulinumtoxina, 5 units | Carrier judgment | — | 8 |
| J0587 | Injection, rimabotulinumtoxinb, 100 units | Special coverage instructions apply | — | 8 |
| J0589 | Injection, daxibotulinumtoxina-lanm, 1 unit | Carrier judgment | — | 8 |
| G0340 | Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment | Carrier judgment | — | 2 |
| G0339 | Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment | Carrier judgment | — | 2 |
| G0563 | Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions | Carrier judgment | — | 1 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior | Carrier judgment | — | 1 |
| G2195 | Patients with clinical indications for imaging of the head: occipital headache in children | Carrier judgment | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 5 |
Medicare policy articles listing G51.33
- A57715: Billing and Coding: Botulinum Toxins (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L33274, L38809
- A58423: Billing and Coding: Botulinum Toxins (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L33274, L38809
- A56874: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (Wellpoint Federal (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L35076
- A57185: Billing and Coding: Botulinum Toxin Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A57186: Billing and Coding: Botulinum Toxin Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59707: Billing and Coding: Botulinum Toxin Injections (Wellpoint Federal (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59714: Billing and Coding: Botulinum Toxin Injections (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59726: Billing and Coding: Botulinum Toxins Injections (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes)
- A59809: Billing and Coding: Botulinum Toxin Injections (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59350: Billing and Coding: Radiation Therapies (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L39553
- A57307: Billing and Coding: Nerve Conduction Studies and Electromyography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A54969: Billing and Coding: Nerve Conduction Studies and Electromyography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
1 more articles list G51.33.
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other G51 diagnoses (Facial nerve disorders)
- G51.31 — Clonic hemifacial spasm, right
- G51.32 — Clonic hemifacial spasm, left
- G51.0 — Bell's palsy
- G51.1 — Geniculate ganglionitis
- G51.2 — Melkersson's syndrome
- G51.4 — Facial myokymia
- G51.8 — Other disorders of facial nerve
- G51.9 — Disorder of facial nerve, unspecified
Frequently asked questions
Does Medicare cover G51.33 (Clonic hemifacial spasm, bilateral)?
Medicare covers items and services, not diagnoses. 16 Medicare billing and coding articles list G51.33 as a covered diagnosis for 18 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 G51.33?
The Level II codes from the policies most specific to this diagnosis are J0585 (Injection, onabotulinumtoxina, 1 unit, 8 articles); J0588 (Injection, incobotulinumtoxin a, 1 unit, 8 articles); J0586 (Injection, abobotulinumtoxina, 5 units, 8 articles); J0587 (Injection, rimabotulinumtoxinb, 100 units, 8 articles); J0589 (Injection, daxibotulinumtoxina-lanm, 1 unit, 8 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list G51.33?
A57715 (Billing and Coding: Botulinum Toxins); A58423 (Billing and Coding: Botulinum Toxins); A56874 (Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)), and 13 more articles.
What is ICD-10-CM code G51.33?
G51.33 is the ICD-10-CM code for clonic hemifacial spasm, bilateral, in category G51 (Facial nerve disorders), chapter 6: Diseases of the nervous system.
Next steps
- Run a reimbursement report for a device billed under J0585
- Watch J0585 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0585
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 6: Diseases of the nervous system · All diagnoses · HCPCS lookup