tci Part B Insider - 2007 Issue 24

PHYSICIAN NOTES: Don't Forget The GS Modifier For High-Hemoglobin ESRD Patients

'Medical home' could improve outcomes for minority patients The Centers for Medicare & Medicaid Services (CMS) will crack down on coverage for erythropoiesis stimulating agents (ESAs) used to treat anemia in patients who receive dialysis for end stage renal disease (ESRD). Since CMS last updated its coverage, the Food & Drug Administration issued a -black box- warning, saying that large doses of ESAs are risky for ESRD patients with hemoglobin levels above 12 g/dL.Effective next January, Medicare will continue to pay the same for ESAs for patients with hemoglobin of between 10 and 12 g/dL. But for patients...

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