ADVATE support for your patients

Takeda is proud to provide a variety of programs and resources for hemophilia A patients.

ADVATE is covered on
over 91% of Commercial and Medicaid Health Plans.1

Source: FINGERTIP FORMULARY®, as of 06/15/2020, is subject to change without notice by a health plan or state.

Product coverage divided by total therapeutic category coverage, based on the Rx and medical coverage using DRG medical lives.

Get started

Download these helpful tools or contact the Hematology Support Center for assistance with accessing ADVATE.

Access tools and resources
Sample letter of medical necessity

Download and use this letter as a template if a payer requires a statement of medical necessity for ADVATE.

PA request form checklist

Reference the items listed in the PA request form checklist as they may be necessary to obtain a prior authorization decision for ADVATE.

Hematology Support Center logo.
Hematology Support Center

Takeda’s Hematology Support Center (HSC) is dedicated to helping patients who have been prescribed Takeda hematology products and healthcare providers who have a patient on or ready to start on a Takeda hematology product. HSC offers help with treatment access, as well as educational resources and information for financial assistance programs. Call 1-888-229-8379 Monday–Friday 8:30AM–8:00PM (ET).

Visit HEMATOLOGYSUPPORTPRO.COM
Access Navigator

Your local Takeda representative can synthesize coverage information by creating Fingertip Formulary® sheets that compare Takeda and non-Takeda product coverage across prescription, medical, and combined benefit programs from different health plans.

Find a rep

ADVATE billing and coding information

Healthcare providers are responsible for ensuring accurate and appropriate diagnostic coding to obtain reimbursement. Use the appropriate codes noted below or download the quick reference ADVATE Billing and Coding sheet.

NDC codes2,3
ADVATE nominal
strength
Factor VIII potency
range
(IU per vial)
NDC codes*
250 IU 200-400 0944-3051-02
375 IU 200-400 0944-3051-02
500 IU 401-800 0944-03052-02
750 IU 401-800 0944-03052-02
1000 IU 801-1200 0944-03053-02
1500 IU 1201-1800 0944-03054-02
1700 IU 1201-1800 0944-03054-02
2000 IU 1801-2400 0944-03045-10
2500 IU 2401-3600 0944-03046-10
3000 IU 2401-3600 0944-03046-10
4000 IU 3601-4800 0944-03047-10
*NDC codes have been formatted to comply with HIPAA guidelines. Please ensure that NDC codes are properly formatted to comply with specific payor requirements, as applicable.
Includes 2 mL sWFi diluent.
Includes 5 mL sWFi diluent.
ICD-10 Diagnosis codes4
ICD-10 Code Description
D66 Hereditary factor VIII deficiency
Healthcare Common Procedure Coding System (HCPCS)5
HCPCS Code [J Code] Description
J7192 Factor VIII (antihemophilic factor,
recombinant) per IU, not otherwise
specified
Current Procedural Terminology codes3
CPT Codes Description
96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug
96376 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure. Do not report 96376 for a push performed within 30 minutes of a reported push of the same substance or drug; 96376 may be reported by facilities only)
Hospital Revenue codes6
Hospital Revenue Codes Description
0636 Pharmacy, drugs requiring detailed coding.
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Find tools your patients can use
Learn more
  1. Decision Resources Group. Fingertip Analytics reporting tool. Accessed July 10, 2019.
  2. Advate. Prescribing information. Baxalta US Inc; 2018.
  3. Takeda data on file.
  4. ICD-10-CM tabular list of diseases and injuries 2019. Centers for Disease Control and Prevention. Accessed October 2, 2019. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2019/icd10cm_tabular_2019.pdf
  5. 2019 Alpha-Numeric HCPCS file. Centers for Medicare & Medicaid Services. Accessed October 2, 2019. https://www.cms.gov/medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS-Items/2019-Alpha-Numeric-HCPCS-File
  6. Medicare claims processing manual. Centers for Medicare & Medicaid Services. Accessed October 2, 2019. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c18.pdf