Medicare Part B covers blood clotting factors and related items used for the administration of such factors for hemophilia patients competent to use such factors without medical supervision. Hemophilia encompasses the following conditions:
The Centers for Medicare & Medicaid Services (CMS) requires all Medicare Advantage (MA) organizations to provide general compliance and fraud, waste, and abuse (FWA) training to all of its first tier, downstream and/or related entities (FDRs).
Effective May 1, 2017, PacificSource will no longer accept provider-based billing of office services, regardless of the office location. We will deny as noncovered any office services billed on a UB claim form, and you will need to resubmit them in the correct format.
Please be aware of the Interim instructions for billing this item. As this code will be billed with an unlisted HCPC code of E1399, PacificSource will require an invoice at the time of billing.