tci Part B Insider - 2004 Issue 25

EPO POLICY GETS A CHECK-UP

Get the lowdown on proposed changes to monitoring procedures A draft revised policy from the Centers for Medicare & Medicaid Services issued July 8 could pave the way for smarter coverage of your end stage renal disease patients. But first CMS wants to hear your take. For potentially anemic patients, the draft policy would monitor: both hemocrit and hemoglobin levels; the incentives that exist to keep these levels in the 'target range'; and excessive dosing of erythropoietin. CMS currently restricts reimbursement for EPO claims to a post-payment review of beneficiaries who claim a rolling average hematocrit level of 37...

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