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Official Description

Injection, emicizumab-kxwh, 0.5 mg
Short Descr Inj., emicizumab-kxwh 0.5 mg
Related Drugs Hemlibra
Coverage Carrier Priced
Pricing Indicator(s) 51 – Drugs
MPI A – Not applicable, as HCPCS priced under one methodology
ASC Payment Group Code YY – 1/01/2019
BETOS O1E – Other drugs
TOS Code(s) 1 – Medical care
Added Date 1/1/2019
Status Code Excluded from Physician Fee Schedule by Regulation
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals
ASC Payment Indicator Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate.
MUE 1800
MUE Not applicable/unspecified.
OTS Orthotic No
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
JZ Zero drug amount discarded/not administered to any patient
TB Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
JG Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
UD Medicaid level of care 13, as defined by each state
KX Requirements specified in the medical policy have been met
KP First drug of a multiple drug unit dose formulation
KQ Second or subsequent drug of a multiple drug unit dose formulation
JW Drug amount discarded/not administered to any patient
GW Service not related to the hospice patient's terminal condition
CR Catastrophe/disaster related
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GZ Item or service expected to be denied as not reasonable and necessary
Date
Action
Notes
2019-01-01 Added Code added.
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