EPO/DPA and Anemia of Chronic Disease (Policy INJ-023)
Effective for dates of service April 1, 2007, and after, documentation no longer is required with the initial EPO/DPS claim. The EJ modifier will no longer be required with subsequent claims. To bill for anemia of chronic disease, use ICD-9 code 285.29 (Anemia of other chronic disease). The ICD-9 code for the cause of the anemia, must be placed in 2300 Loop, HI Segment for electronic claims (item 21, #1 for CMS 1500 forms) and a pointer of 1 in Loop 2400, SV1 segment for electronic claims (#1 in item 24E on the CMS 1500 form). Supporting documentation must be contained in the medical record and be available to Medicare upon request only.
Please see the March 2007 Communiqué for a policy update.
Page Last Updated: Thursday, 18-Mar-2010 05:55:31 CDT
