How To Use HCPCS Code C9140

HCPCS code C9140 describes the injection of factor VIII, also known as antihemophilic factor, recombinant, in a unit dose. This code is used to identify the administration of this specific medication for the treatment of hemophilia A, a genetic disorder that impairs the blood’s ability to clot properly. Factor VIII is a clotting protein that is essential for normal blood clotting, and its deficiency in individuals with hemophilia A can lead to excessive bleeding and other complications.

1. What is HCPCS C9140?

HCPCS code C9140 is a specific code that is used to identify the injection of factor VIII (antihemophilic factor, recombinant) in a unit dose. This code is assigned to the medication Afstyla, which is a recombinant factor VIII product used for the treatment of hemophilia A. It is important to note that this code is specific to the injection of factor VIII and should not be used for any other medications or procedures.

2. Official Description

The official description of HCPCS code C9140 is “Injection, factor VIII (antihemophilic factor, recombinant) (afstyla), 1 i.u.” This description accurately reflects the nature of the code, indicating that it is used to identify the injection of recombinant factor VIII, specifically the medication Afstyla, in a unit dose.

3. Procedure

1. Prepare the medication: Before administering the injection, the healthcare provider must ensure that the medication is properly prepared according to the manufacturer’s instructions. This may involve reconstituting the medication with a diluent or preparing it in a specific manner.
2. Verify patient information: The healthcare provider should confirm the patient’s identity and ensure that the correct medication and dose are being administered.
3. Select the injection site: The provider will choose an appropriate injection site, typically a vein, for the administration of the medication.
4. Administer the injection: Using a sterile syringe and needle, the healthcare provider will inject the recombinant factor VIII medication into the selected site.
5. Monitor the patient: After the injection, the provider will closely monitor the patient for any adverse reactions or complications.

4. When to use HCPCS code C9140

HCPCS code C9140 should be used when administering the medication Afstyla, which is a recombinant factor VIII product, to patients with hemophilia A. It is important to ensure that the patient meets the criteria for receiving this medication and that it is medically necessary for their condition. This code should not be used for any other medications or procedures.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of factor VIII (antihemophilic factor, recombinant) using HCPCS code C9140, healthcare providers should ensure that the following documentation is included:

• Medical record documentation supporting the medical necessity of the medication
• Documentation of the patient’s diagnosis of hemophilia A
• Details of the medication administered, including the dose and route of administration
• Documentation of any complications or adverse reactions that may have occurred

Providers should also follow the billing guidelines set forth by Medicare or other insurance carriers to ensure proper reimbursement for the service.

6. Historical Information and Code Maintenance

HCPCS code C9140 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has been in use since then to identify the injection of factor VIII (antihemophilic factor, recombinant) in a unit dose. However, it is important to note that this code was terminated on December 31, 2017. This means that it is no longer valid for use in billing or reporting purposes.

7. Medicare and Insurance Coverage

Medicare and other insurance carriers may provide coverage for the administration of factor VIII (antihemophilic factor, recombinant) using HCPCS code C9140. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are some examples of when HCPCS code C9140 should be billed:

1. A 35-year-old male with a diagnosis of hemophilia A receives an injection of Afstyla, a recombinant factor VIII product, at a hemophilia treatment center.
2. A 10-year-old female with severe hemophilia A undergoes a routine prophylactic injection of factor VIII to prevent bleeding episodes.
3. A 50-year-old male with hemophilia A receives an injection of factor VIII prior to undergoing a surgical procedure to ensure proper blood clotting.
4. A 25-year-old pregnant female with hemophilia A receives regular injections of factor VIII throughout her pregnancy to prevent bleeding complications.
5. A 60-year-old male with hemophilia A receives an injection of factor VIII following a traumatic injury to promote clotting and prevent excessive bleeding.