Table of content for "Adynovate factor viii recom" (HCPCS C9137)
General information on the “C9137” code
HCPCS Code: C9137
Long Description: Injection, factor viii (antihemophilic factor, recombinant) pegylated, 1 i.u.
Short Description: Adynovate factor viii recom
Original information is taken from C9137 page
Pricing indicators
Pricing Indicator Code 1: 53 – Statute
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Statute Number: 1833(T)
Cross Reference Code 1: J7207 ;
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 9 – Other medical items or services
Type Of Service 2: F – Ambulatory surgical center (facility usage for surgical services)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20160401
Code Effective Date: 20170101
Termination Date: 20161231
Action Code: N – No maintenance for this code