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Your local Takeda representative can synthesize coverage information by creating Fingertip Formulary® sheets that compare Takeda and non-Takeda product coverage across prescription, medical, and combined benefit programs from different health plans.
Healthcare providers are responsible for ensuring accurate and appropriate diagnostic coding to obtain reimbursement. Use the appropriate codes noted below or download the quick reference ADVATE Billing and Coding sheet.
*NDC codes have been formatted to comply with HIPAA guidelines. Please ensure that NDC codes are properly formatted to comply with specific payor requirements, as applicable.
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug
96376
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure. Do not report 96376 for a push performed within 30 minutes of a reported push
of the same substance or drug; 96376 may be reported by facilities only)
CONTRAINDICATIONS: Patients who have life-threatening hypersensitivity reactions, including anaphylaxis, to mouse or hamster protein or other constituents of the product.
Advate. Prescribing information. Baxalta US Inc; 2018.
Takeda data on file.
ICD-10-CM tabular list of diseases and injuries 2019. Centers for Disease Control and Prevention. Accessed October 2, 2019. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2019/icd10cm_tabular_2019.pdf
2019 Alpha-Numeric HCPCS file. Centers for Medicare & Medicaid Services. Accessed October 2, 2019. https://www.cms.gov/medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS-Items/2019-Alpha-Numeric-HCPCS-File
Medicare claims processing manual. Centers for Medicare & Medicaid Services. Accessed October 2, 2019. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c18.pdf
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