LCD/NCD Portal

NCD110.3

 

ANTI-INHIBITOR COAGULANT COMPLEX (AICC)

 

 

Effective Date of this Version

 

• This is a longstanding national coverage determination.

• The effective date of this version has not been posted.

 

 

Benefit Category

 

• Blood Clotting Factors for Hemophilia Patients

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

 

Indications and Limitations of Coverage

 

• Anti-inhibitor coagulant complex, AICC, is a drug used to treat hemophilia in patients with factor VIII inhibitor antibodies.

• AICC has been shown to be safe and effective and has Medicare coverage when furnished to patients with

o Hemophilia A

o Inhibitor antibodies to factor VIII

o Who have major bleeding episodes

o Who fail to respond to other, less expensive therapies

 

 

Medicare NCD Link