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Oncology & Hematology Coding Alert

Ease Your J0881, J0885 ESA Coding Woes Today

Published on Mon Apr 20, 2009

Have you sent your software vendor this crucial instruction? CMS released a slew of documents in 2008 explaining billing requirements for non-ESRD ESA treatment. But even so, one crucial element -- covered diagnoses -- requires some detective work. Simplify your trek through the various documents -- and find out what they-re missing -- with our expert coding guides. Term tip: Be sure you-ve memorized these two acronyms before you begin: - ESRD = End Stage Renal Disease - ESA = Erythropoiesis Stimulating Agent. Collect the CMS ESA Guidance Docs You Need You may want to print the following CMS documents or bookmark them on your computer for reference: 1. National Coverage Determination (NCD) for Erythropoiesis Stimulating Agents (ESAs) in Cancer andRelated Neoplastic Conditions (110.21): www.cms.hhs.gov/mcd/search.asp The NCD lists nationally covered and non-covered indications. 2. CMS Transmittal 1412, Change Request 5699: www.cms.hhs.gov/transmittals/downloads/R1412CP.pdf MLN Matters article MM5699: www.cms.hhs.gov/MLNMattersArticles/downloads/MM5699.pdf The two above [...]
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