CSHCN 2009 > Hospital > Inpatient/Outpatient Benefits, Limitations, and Authorization Requirements

22.2.1 Blood Factor Products

The CSHCN Services Program may consider reimbursement for blood factor products and other pharmaceuticals for program-eligible clients. The use of blood factor products is diagnosis-restricted and requires authorization.

When submitting claims, providers must identify products using either product names and manufacturers or the National Drug Codes (NDCs), and the following procedure codes:

Note: Authorization requests must also be submitted for clients who receive blood factor products in the emergency department.

Refer to: Section 4.2, "Authorizations" for more information, including deadlines and appeals procedures.

Section 29.2.8, "Blood Factor Products" for additional information.