MedicaidBilling CodesMedium impact
2023.06 Provider Bulletin - Updated Billing Instructions for Sevenfact pdf
Connecticut Medicaid (HUSKY Health)·CT · Hematology, Oncology·Provider Bulletin
We identified it
Jun 20, 2026
Summary
Effective immediately, pharmacy providers must change billing units for Sevenfact (coagulation factor VIIa) from vials to micrograms due to manufacturer price corrections. This affects NDCs 71127-1000-01 and 71127-5000-01, aligning with NCPDP Billing Unit Standard policy for antihemophilic factors.
Action Required
Immediately: Pharmacy billing team must update billing system to bill Sevenfact (NDCs 71127-1000-01 and 71127-5000-01) with units in micrograms instead of vials. Continue billing each unit as 'Each' in Field 12 of NCPDP forms and maintain electronic claim submission during the Temporary Effective Period for coagulation factor drugs.