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September 15, 2014 – Updated 06.08.15

Reminder: Hemophilia Drugs

Hemophilia drugs submitted electronically should be billed as indicated below.

  • Loop 2400, Segment SV104 is a 5 bytes numeric decimal implied field.
    • For example, to bill for 8,400 units, the SV104 segment will show '84000' to account for the implied decimal.
    • For any unit of service that exceeds 9,999 units, please bill '1' unit of service and enter the actual units in Loop 2400 Segment NTE. We will manually process these claims.
  • For Hemophilia drugs submitted via the CMS-1500 claim form, a unit of '1' should be indicated in Item 24G.
    • In Item 19, please enter the actual number of units. We will manually process these claims.

When billing for Hemophilia drugs, please keep this in mind to ensure you are billing correctly. We will begin processing claims based on these guidelines on October 15, 2014. If Hemophilia drugs are not billed as indicated above, this could result in underpayment due to incorrect billing.

Reviewed: 12.09.22


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