Billing and Coding: Hemophilia Factor Products

This policy governs billing/coding for hemophilia clotting factor products billed to Medicare — products are payable when billed correctly, and non-covered services must not be billed as covered and should be reported with the appropriate non‑coverage modifier. Key requirements: translate the administered dose into the HCPCS‑specified units (IU, mg, mcg) using the long code descriptor and report the correct Quantity Billed (QB); for Part B drugs (except CAP) use modifier JW to identify discarded unused single‑dose/single‑use product (JZ to indicate no wastage) and retain wastage documentation and supporting medical records.

"wastage_documentation"

Sign up to see full coverage criteria, indications, and limitations.