L74.52: Secondary focal hyperhidrosis
L74.52, secondary focal hyperhidrosis, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 5 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 5 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 L74.52 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 | — | 6 |
| J0588 | Injection, incobotulinumtoxin a, 1 unit | Carrier judgment | — | 6 |
| J0586 | Injection, abobotulinumtoxina, 5 units | Carrier judgment | — | 6 |
| J0587 | Injection, rimabotulinumtoxinb, 100 units | Special coverage instructions apply | — | 6 |
| J0589 | Injection, daxibotulinumtoxina-lanm, 1 unit | Carrier judgment | — | 6 |
Medicare policy articles listing L74.52
- 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
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 L74 diagnoses (Eccrine sweat disorders)
- L74.510 — Primary focal hyperhidrosis, axilla
- L74.511 — Primary focal hyperhidrosis, face
- L74.512 — Primary focal hyperhidrosis, palms
- L74.513 — Primary focal hyperhidrosis, soles
- L74.519 — Primary focal hyperhidrosis, unspecified
- L74.8 — Other eccrine sweat disorders
- L74.9 — Eccrine sweat disorder, unspecified
Frequently asked questions
Does Medicare cover L74.52 (Secondary focal hyperhidrosis)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list L74.52 as a covered diagnosis for 5 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 L74.52?
The Level II codes from the policies most specific to this diagnosis are J0585 (Injection, onabotulinumtoxina, 1 unit, 6 articles); J0588 (Injection, incobotulinumtoxin a, 1 unit, 6 articles); J0586 (Injection, abobotulinumtoxina, 5 units, 6 articles); J0587 (Injection, rimabotulinumtoxinb, 100 units, 6 articles); J0589 (Injection, daxibotulinumtoxina-lanm, 1 unit, 6 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list L74.52?
A57185 (Billing and Coding: Botulinum Toxin Injections); A57186 (Billing and Coding: Botulinum Toxin Injections); A59707 (Billing and Coding: Botulinum Toxin Injections), and 3 more articles.
What is ICD-10-CM code L74.52?
L74.52 is the ICD-10-CM code for secondary focal hyperhidrosis, in category L74 (Eccrine sweat disorders), chapter 12: Diseases of the skin and subcutaneous tissue.
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 12: Diseases of the skin and subcutaneous tissue · All diagnoses · HCPCS lookup