AHA Coding Clinic® for HCPCS - 2004 Issue 1; FOR your INFORMATION
New coding instructions for ESRD services
According to Transmittal 39, posted Jan. 6, 2004, CMS recently rescinded the usage of HCPCS codes (Q9920 through Q9940) for the billing and reporting of epoetin alfa (EPO). Therefore, for services furnished on or after Jan. 1, 2004, renal providers will no longer be able to use these Q codes for EPO. CMS has established a new HCPCS code for the billing of darbepoetin alfa. Effective for services provided on or after Jan. 1, 2004, code Q4054, Injection, darbepoetin alfa, 1 mcg (for ESRD on dialysis) will be reported for treatment of anemia in end-stage renal disease (ESRD) patients...
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Article Overview
This brief coding update summarizes a CMS transmittal affecting end-stage renal disease (ESRD) services, with emphasis on revised HCPCS reporting for dialysis-related anemia treatment and the timing of the change. It is relevant to renal providers, coders, and billing staff who track Medicare guidance and HCPCS updates for ESRD care.
Why This Topic Matters
Providers and coders need to know which HCPCS reporting instructions changed and when the new reporting guidance took effect so ESRD dialysis claims are coded consistently with CMS policy.
What You Will Learn
- What CMS changed for ESRD-related HCPCS billing
- Which service dates are affected by the update
- What general areas of ESRD anemia treatment reporting are addressed in the guidance
- Where CMS directs readers for additional information
Who Should Read This
- Medical coders
- Billing staff
- Renal providers
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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