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11th Annual Johns Hopkins Dystonia & Spasticity Practicum & Update:
Administrative Aspects of Toxin Injections in Managed Care

Presented by the Johns Hopkins University School of Medicine

This activity is supported by educational grants and in-kind support from Allergan, Inc., Ipsen Biopharmaceuticals, Inc., Merz North America, Inc., and US Worldmeds, LLC.


While botulinum toxins can be an effective treatment option for patients with dystonia and spasticity, their clinical utility can feel cumbersome and complicated from an administrative perspective. This educational activity will provide a comprehensive update on the clinical applications of botulinum toxins, as well as practical strategies for their effective implementation, while accounting for managed care considerations. Specifically, it will address effective methods for obtaining consent, proper coding and billing, and documentation requirements, as well as other strategies to facilitate appropriate access to botulinum toxin therapies.


The goal of this activity is to offer clinicians insights and strategies for facilitating access to, and the appropriate use/management of, botulinum toxin therapy in patients with dystonia and spasticity.


This activity is intended for neurology and physical medicine and rehabilitation residents and fellows, as well as community neurologists, physiatrists, physical, and occupational therapists. No prerequisites required.


After participating this activity, the participant will demonstrate the ability to:

  • RECOGNIZE the varied clinical applications of available botulinum toxin preparations.
  • IMPLEMENT practical strategies, including consent and documentation, to improve the office-based use of botulinum toxin preparations.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

accme_logo Accreditation Statement — The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement — The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

After reviewing this online activity, participants may receive a certificate by receiving a score of 70% or higher on the CME test and completing an evaluation. A certificate of participation will be available online immediately following successful completion of the activity.

The estimated time to complete this activity: 60 minutes.

Release date:  May 11, 2018     Expiration date:  May 11, 2020


Zoltan Mari, MD
Adjunct Associate Professor of Neurology
Johns Hopkins University School of Medicine
Baltimore, Maryland
Director, Parkinson and Movement Disorders Program
Cleveland Clinic Lou Ruvo Center for Brain Health
Clinical Professor of Neurology
University of Nevada
Las Vegas, Nevada
Policy on Speaker and Provider Disclosure
It is the policy of the Johns Hopkins University School of Medicine that the speaker and provider globally disclose conflicts of interest. The Johns Hopkins University School of Medicine OCME has established policies that will identify and resolve conflicts of interest prior to this educational activity. Detailed disclosure will be made prior to presentation of the education.

Full Disclosure Policy Affecting CME Activities
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) requires attested and signed global disclosure of the existence of all financial interests or relationships with commercial interest from any individual in a position to control the content of a CME activity sponsored by OCME.

The following relationships have been reported for this activity:

Planner Disclosures
Dr. Mari reports serving as a principal investigator for Great Lakes NeuroTechnologies and Sunovion Pharmaceuticals, Inc; and serving as a consultant for AbbVie, Inc. and Revance Therapeutics, Inc.

No other planners or faculty members have indicated that they have any financial interests or relationships with a commercial entity whose products or services are relevant to the content of their presentation(s).

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

Off-Label Product Discussion
The following chair/planner has disclosed that their presentation will reference unlabeled/unapproved uses of drugs or products:

Dr Mari – Botulinum toxins and the use of brand names throughout the activity.

No other faculty has indicated that he/she will reference unlabeled/unapproved uses of drugs or products.

The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.
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Reviewed & Approved by:
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(Updated 4/09 and 3/14)

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The following is an interactive case simulation designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited preassessment, an interactive case study, and a CME postassessment and evaluation. All 3 sections must be completed to receive CME credit. A certificate of participation will be available online immediately following successful completion of the activity.


Administrative Aspects of Toxin Injections in Managed Care
Zoltan Mari, MD

Postassessment and Evaluation

This activity was developed in collaboration with ASiM.

procced to pretest

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