New Hemophilia Clotting Factor and HCPCS Code

Effective for outpatient claims with dates of service on or after April 1, 2008, Health Care Procedure Code System (HCPCS) Level II code Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified), per I.U. VWF:RCO VWF complex, NOS is payable for Medicare.

Local carriers and MACs will process non-institutional blood clotting factor Part B claims. Hospitals subject to the Outpatient Prospective Payment System (OPPS) will be paid the ambulatory payment classification (APC) for the clotting factors; and SNFs will be paid based on cost.

Read the CMS transmittal 1564, CR6006, on which this report is based, on the CMS Web site.


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