36.4.43.3 Epoetin Alfa (Erythropoietin; EPO)EPO is a glycoprotein that stimulates red blood cell formation and production of the precursor red blood cells of bone marrow. EPO is indicated for anemia associated with chronic renal failure, including patients on dialysis (ESRD) and patients not on dialysis. In chronic ESRD patients, the increased BUN impairs the production of erythropoietin, leading to a chronic anemia. EPO procedure codes used to bill for treatment of anemia associated with ESRD patients receiving dialysis are for a quantity of 1 for every 1,000 units. The exact dose should be stated on the claim. Example: If a client has an HCT of 34 percent with a diagnosis of ESRD and is given 5,000 units of EPO, bill a quantity of 5 with procedure code 1-J0886. EPO is limited to three injections per calendar week (Sunday through Saturday). Refer to: "Erythropoietin Alfa (EPO)" for more information on EPO. EPO is payable in the following POSs:
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Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved. |
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