tci Part B Insider - 2004 Issue 3

Drug Coding: CMS Throws Practices a Curve Ball With J0880 Reversal

You have two choices of codes for non-ESRD Aranesp claimsThe Centers for Medicare & Medicaid Services flip-flopped on an important new drug code, and the result is confusion for coders. First CMS said that J0880 Injection, darbepoetin alfa, 5 mcg) wouldn't be payable by Medicare after Jan. 1, 2004. Then in late December, CMS changed its tune and said J0880 would remain payable, but only for claims in the physician office.  Complicating matters, CMS recognizes two Q codes for darbepoetin alfa, otherwise known as Aranesp. For patients with ESRD receiving Aranesp, you should use new code Q4054...

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