Reporting of Hematocrit or Hemoglobin Levels on All Claims for the Administration of Erythropoiesis Stimulating Agents (ESAs), Implementation of New Modifiers for Non-ESRD Indications, and Reporting of Hematocrit/Hemoglobin Levels on all Non-ESRD, Non-ESA Claims Requesting Payment for Anti-Anemia Drugs
Effective for all claims requesting payment for the administration of ESAs with dates of service on and after January 1, 2008, CMS, in conjunction with section 110 of Division B of the Tax Relief and Health Care Act legislation of 2006, will require that the most recent hematocrit and/or hemoglobin levels be reported, along with one of three designated modifiers. CR 5699 does not pertain to
72X claims since renal dialysis facilities are already reporting. Additionally, for non-ESRD, non-ESA claims requesting payment for the administration of Part B anti-anema drugs used in the treatment of cancer that are not-self-administered, shall also report either the most recent hematocrit or hemoglobin level.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 11, 2008
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