Since 1989, April 17 is observed as World Hemophilia Day to honor Frank Schnabel, the founder of the World Federation of Hemophilia (WFH). The day aims at bringing the global bleeding disorders community together. The theme of the event this year is “Adapting to change: sustaining care in a new world”. In 2021, this awareness day also highlights that COVID-19 pandemic has a major impact on people with a bleeding disorder. Hemophilia is treated by a doctor who specializes in blood disorders or hematologist. Professional medical billing services are available for hematologists to submit error-free claims to insurers and receive proper reimbursement.

Hemophilia is defined as an inherited bleeding disorder in which the blood does not clot properly. The blood fails to clot and abnormal bleeding occurs. The blood contains many proteins called clotting factors that help to stop bleeding. People with hemophilia have low levels of either Factor VIII (8) or factor IX (9). There are two types of hemophilia – Hemophilia A and Hemophilia B. Hemophilia A or Classic Hemophilia is caused by a lack or decrease of clotting factor VIII, while Hemophilia B or Christmas Disease is caused by a lack or decrease of clotting factor IX. According to the CDC, Hemophilia A affects 1 in 5,000 male births and about 400 babies are born with hemophilia A each year.

The lower amount of factor indicates that bleeding may occur which can lead to serious health problems. Hemophilia can lead to bleeding within joints that result in chronic joint disease and pain, bleeding in the head that cause long-term problems such as seizures and paralysis or even death, if bleeding cannot be stopped. Diagnosis of hemophilia is done mainly by taking a blood sample and testing the levels of clotting factor VIII & IX. This bleeding disorder is treated mainly by replacing the missing blood clotting factor or infusing so that the blood can clot properly.
Types, diagnosis and treatments for hemophilia can be accurately reported using ICD-10 and HCPCS codes on medical claims to submit to insurers to get accurate reimbursement.

• D66 Hereditary factor VIII deficiency
• D67 Hereditary factor IX deficiency
• D68.0 Von Willebrand’s disease
• D68.1 Hereditary factor XI deficiency
• D68.3 Hemorrhagic disorder due to circulating anticoagulants
• D68.311 Acquired hemophilia
• D68.312 Antiphospholipid antibody with hemorrhagic disorder
• D68.318 Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors
• D68.4 Acquired coagulation factor deficiency

People also use self-injectable medications to reduce the frequency of bleeding episodes. HEMLIMBRA is one such approved prophylactic medicine for adults and children with congenital factor VIII deficiency hemophilia A with factor VIII inhibitors and the drug is self-administered subcutaneously, weekly. Usage of this drug can be reported using HCPCS code.

• Q9995 Injection, emicizumab-kxwh, 0.5 mg

Other HCPCS codes for blood-clotting factors and injections are

• J7170 Injection, emicizumab-kxwh, 0.5 mg
• J7175 Injection, factor X, (human), 1 IU
• J7179 Injection, von Willebrand factor (recombinant), (Vonvendi), 1 IU VWF:RCo
• J7180 Injection, factor XIII (antihemophilic factor, human), 1 IU
• J7181 Injection, factor XIII A-subunit, (recombinant), per IU
• J7182 Injection, factor VIII, (antihemophilic factor, recombinant), (NovoEight), per IU
• J7183 Injection, von Willebrand factor complex (human), Wilate, 1 IU vWF:RCo
• J7185 Injection, factor VIII (antihemophilic factor, recombinant) (Xyntha®), per IU
• J7186 Injection, antihemophilic factor VIII/von Willebrand factor complex (human), per
  factor VIII IU
• J7187 Injection, von Willebrand factor complex (Humate-P®), per IU VWF:RCO
• J7188 Injection, factor VIII (antihemophilic factor, recombinant), (Obizur), per IU
• J7189 Factor VIIa (antihemophilic factor, recombinant), per 1 mcg
• J7190 Factor VIII (antihemophilic factor, human), per IU
• J7191 Factor VIII (antihemophilic factor (porcine)), per IU
• J7192 Factor VIII (antihemophilic factor, recombinant), per IU, not otherwise specified
• J7193 Factor IX (antihemophilic factor, purified, non-recombinant), per IU
• J7194 Factor IX, complex, per IU
• J7195 Injection, factor IX (antihemophilic factor, recombinant) per IU, not otherwise
  specified
• Q4096 Injection, Von Willebrand factor complex, human, ristocetin cofactor (not otherwise specified)

COVID-19 and Hemophilia

Hemophilia News Today has pointed out that individuals of any age with blood disorders such as hemophilia, porphyria, and sickle cell disease are at increased risk of developing serious COVID-19 symptoms and they should take extra precautions to minimize the risk of getting COVID-19. It is recommended that such patients keep their blood pressure in check and follow general guidelines to keep their immune system strong. To avoid getting infected by COVID-19, they should follow preventive measures such as stocking up on necessary medications and supplies that can last for a few weeks, avoid crowds and unnecessary travel, stay at home as much as possible and consult their healthcare providers in case of any COVID-19-like symptoms.

Physicians treating COVID-19, hemophilia or any bleeding disorders can consider partnering with an experienced medical billing and coding company to assign the correct codes on medical claims.

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