Tips to bill properly for Epogen and Procrit for renal disease patients

Why This Topic Matters

Claims for these therapies may be reviewed closely by carriers, and practices need to understand the broad compliance and documentation issues involved when billing drug administration and related services.

Article Sections

1. Overview of billing scrutiny and hematocrit monitoring

   Introduces the billing environment for renal disease patients receiving erythropoiesis-stimulating therapy. It discusses carrier review concerns, CMS guidance references, and the role of hematocrit monitoring.

2. Billing EPO and 99211

   Addresses the relationship between injection claims and same-day nurse visit claims. It also references the related administration coding discussed in the article.

3. Billing Procrit

   Summarizes the article’s general discussion of Procrit billing, carrier-specific coding, and related eligibility considerations for renal patients.